- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.87 / $2,479.00 / $9,713.59
| Facility | | $494.87 | $2,479.00 | $9,713.59 |
- 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
- $550.00 / $1,759.11 / $2,530.00
| Facility | | $550.00 | $1,759.11 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,787.72 / $2,832.84 / $26,542.00
| Facility | | $2,787.72 | $2,832.84 | $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 |