- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.22 / $2,744.19 / $7,227.36
| Facility | | $420.22 | $2,744.19 | $7,227.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.00 / $2,291.00 / $3,514.00
| Facility | | $1,417.00 | $2,291.00 | $3,514.00 |
- 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
- $1,243.76 / $4,754.80 / $26,542.00
| Facility | | $1,243.76 | $4,754.80 | $26,542.00 |
- 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 |