- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,180.07 / $8,229.00
| Facility | | $860.00 | $1,180.07 | $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
- $1,173.82 / $1,584.97 / $1,828.37
| Facility | | $1,173.82 | $1,584.97 | $1,828.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,391.52 / $1,391.52 / $1,458.45
| Facility | | $1,391.52 | $1,391.52 | $1,458.45 |
- 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 |