- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.00 / $1,302.51 / $8,229.00
| Facility | | $787.00 | $1,302.51 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.00 / $10,990.10 / $30,856.09
| Facility | | $8,584.00 | $10,990.10 | $30,856.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,287.54 / $1,767.21 / $2,398.35
| Facility | | $1,287.54 | $1,767.21 | $2,398.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,551.82 / $1,551.82 / $1,551.82
| Facility | | $1,551.82 | $1,551.82 | $1,551.82 |
- 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 |