- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.55 / $2,258.00 / $7,732.42
| Facility | | $251.55 | $2,258.00 | $7,732.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.00 / $3,485.00 / $5,737.00
| Facility | | $1,678.00 | $3,485.00 | $5,737.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.00 / $1,759.11 / $2,530.00
| Facility | | $525.00 | $1,759.11 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.90 / $1,104.18 / $26,542.00
| Facility | | $1,083.90 | $1,104.18 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,257.00 / $4,099.00
| Facility | | $875.00 | $2,257.00 | $4,099.00 |