- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.74 / $2,011.00 / $7,602.00
| Facility | | $415.74 | $2,011.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.00 / $3,688.00 / $6,090.00
| Facility | | $1,676.00 | $3,688.00 | $6,090.00 |
- 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
- $1,012.24 / $1,094.02 / $12,000.00
| Facility | | $1,012.24 | $1,094.02 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,626.00 / $6,291.00
| Facility | | $1,794.00 | $3,626.00 | $6,291.00 |