- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.00 / $3,506.00 / $10,439.00
| Facility | | $1,023.00 | $3,506.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.00 / $911.76 / $1,543.97
| Facility | | $653.00 | $911.76 | $1,543.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $993.00 / $1,098.00 / $1,284.00
| Facility | | $993.00 | $1,098.00 | $1,284.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.50 / $212.43 / $1,925.00
| Facility | | $153.50 | $212.43 | $1,925.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,127.41 / $3,918.00
| Facility | | $816.00 | $2,127.41 | $3,918.00 |