- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,529.36 / $8,229.00
| Facility | | $860.00 | $1,529.36 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $9,592.68 / $21,957.82
| Facility | | $7,212.00 | $9,592.68 | $21,957.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,227.98 / $1,684.30 / $1,942.96
| Facility | | $1,227.98 | $1,684.30 | $1,942.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,287.73 / $1,476.55 / $1,476.55
| Facility | | $1,287.73 | $1,476.55 | $1,476.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |