- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.19 / $5,000.27 / $7,838.38
| Facility | | $307.19 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,835.94 / $6,357.37 / $9,865.12
| Facility | | $1,835.94 | $6,357.37 | $9,865.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $1,300.00 / $1,300.00
| Facility | | $1,300.00 | $1,300.00 | $1,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.39 / $223.30 / $372.47
| Facility | | $104.39 | $223.30 | $372.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.00 / $5,971.00 / $8,422.00
| Facility | | $639.00 | $5,971.00 | $8,422.00 |