- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.00 / $1,147.78 / $8,229.00
| Facility | | $787.00 | $1,147.78 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,744.00 / $7,466.00 / $13,370.00
| Facility | | $3,744.00 | $7,466.00 | $13,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.30 / $1,460.82 / $1,685.15
| Facility | | $1,064.30 | $1,460.82 | $1,685.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,281.96 / $1,281.96 / $1,281.96
| Facility | | $1,281.96 | $1,281.96 | $1,281.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.00 / $1,475.00 / $19,776.00
| Facility | | $847.00 | $1,475.00 | $19,776.00 |