- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.24 / $1,791.00 / $7,003.21
| Facility | | $450.24 | $1,791.00 | $7,003.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,343.00 / $2,151.00 / $2,849.00
| Facility | | $1,343.00 | $2,151.00 | $2,849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,622.00 / $1,774.32 / $12,000.00
| Facility | | $1,622.00 | $1,774.32 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $2,297.00 / $4,099.00
| Facility | | $1,130.00 | $2,297.00 | $4,099.00 |