- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,274.14 / $8,229.00
| Facility | | $860.00 | $1,274.14 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,642.27 / $8,584.00 / $14,014.53
| Facility | | $4,642.27 | $8,584.00 | $14,014.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.47 / $1,621.63 / $1,870.66
| Facility | | $1,181.47 | $1,621.63 | $1,870.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,422.08 / $1,422.08 / $1,613.91
| Facility | | $1,422.08 | $1,422.08 | $1,613.91 |
- 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 |