- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.51 / $3,335.85 / $9,905.04
| Facility | | $596.51 | $3,335.85 | $9,905.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.00 / $3,744.00 / $5,774.00
| Facility | | $1,678.00 | $3,744.00 | $5,774.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.00 / $1,754.69 / $3,203.00
| Facility | | $455.00 | $1,754.69 | $3,203.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.58 / $7,909.30 / $26,542.00
| Facility | | $1,703.58 | $7,909.30 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,351.00 / $6,285.00
| Facility | | $1,000.00 | $3,351.00 | $6,285.00 |