- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,169.38 / $8,229.00
| Facility | | $860.00 | $1,169.38 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.90 / $9,565.00 / $21,322.13
| Facility | | $7,062.90 | $9,565.00 | $21,322.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.79 / $1,488.30 / $1,716.86
| Facility | | $1,089.79 | $1,488.30 | $1,716.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,133.36 / $1,311.44 / $1,311.44
| Facility | | $1,133.36 | $1,311.44 | $1,311.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |