- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,845.00 / $13,232.14
| Facility | | $900.00 | $2,845.00 | $13,232.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,898.80 / $10,230.67 / $14,577.45
| Facility | | $5,898.80 | $10,230.67 | $14,577.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,034.33 / $5,912.71 / $5,912.71
| Facility | | $1,034.33 | $5,912.71 | $5,912.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.00 / $1,802.00 / $1,802.00
| Facility | | $1,802.00 | $1,802.00 | $1,802.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,780.00 / $13,506.00
| Facility | | $1,200.00 | $5,780.00 | $13,506.00 |