- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.00 / $1,431.69 / $8,229.00
| Facility | | $637.00 | $1,431.69 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,470.00 / $8,584.00 / $11,253.00
| Facility | | $5,470.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.72 / $1,384.52 / $1,597.14
| Facility | | $1,008.72 | $1,384.52 | $1,597.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,213.59 / $1,213.59 / $1,213.59
| Facility | | $1,213.59 | $1,213.59 | $1,213.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |