- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.27 / $1,245.00 / $10,561.00
| Facility | | $236.27 | $1,245.00 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,683.54 / $5,683.54 / $8,121.06
| Facility | | $5,683.54 | $5,683.54 | $8,121.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $606.10
| Facility | | $606.10 | $606.10 | $606.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.27 / $356.10 / $556.19
| Facility | | $236.27 | $356.10 | $556.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.50 / $832.00 / $1,928.00
| Facility | | $300.50 | $832.00 | $1,928.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,186.26 / $5,000.00 / $6,821.50
| Facility | | $3,186.26 | $5,000.00 | $6,821.50 |