- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,385.35 / $8,229.00
| Facility | | $860.00 | $1,385.35 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,720.89 / $10,099.00 / $25,551.65
| Facility | | $7,720.89 | $10,099.00 | $25,551.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,291.92 / $1,763.17 / $2,033.95
| Facility | | $1,291.92 | $1,763.17 | $2,033.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,401.22 / $1,552.81 / $1,552.81
| Facility | | $1,401.22 | $1,552.81 | $1,552.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |