- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.00 / $3,506.00 / $10,439.00
| Facility | | $1,361.00 | $3,506.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.00 / $998.01 / $1,050.54
| Facility | | $724.00 | $998.01 | $1,050.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $330.00 / $330.00
| Facility | | $330.00 | $330.00 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.19 / $455.57 / $3,209.69
| Facility | | $227.19 | $455.57 | $3,209.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,565.00
| Facility | | $1,436.00 | $3,096.00 | $5,565.00 |