- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.39 / $1,245.00 / $6,953.60
| Facility | | $420.39 | $1,245.00 | $6,953.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.15 / $1,627.07 / $2,761.08
| Facility | | $1,479.15 | $1,627.07 | $2,761.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.41 / $650.35 / $1,226.89
| Facility | | $338.41 | $650.35 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.00 / $498.30 / $756.52
| Facility | | $372.00 | $498.30 | $756.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,396.82 / $3,590.15 / $12,000.00
| Facility | | $2,396.82 | $3,590.15 | $12,000.00 |