- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.00 / $1,156.31 / $10,152.00
| Facility | | $896.00 | $1,156.31 | $10,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,565.00 / $5,944.00 / $14,034.00
| Facility | | $3,565.00 | $5,944.00 | $14,034.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,001.11 / $1,374.07 / $1,585.09
| Facility | | $1,001.11 | $1,374.07 | $1,585.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.45 / $1,205.45 / $1,205.45
| Facility | | $1,205.45 | $1,205.45 | $1,205.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.00 / $1,475.00 / $12,296.00
| Facility | | $847.00 | $1,475.00 | $12,296.00 |