- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,033.42 / $2,338.48 / $16,467.00
| Facility | | $1,033.42 | $2,338.48 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,392.14 / $7,392.14 / $7,392.14
| Facility | | $7,392.14 | $7,392.14 | $7,392.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.00 / $1,024.74 / $1,756.81
| Facility | | $851.00 | $1,024.74 | $1,756.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |