- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.00 / $4,387.00 / $10,439.00
| Facility | | $1,087.00 | $4,387.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.90 / $2,722.10 / $4,532.57
| Facility | | $1,939.90 | $2,722.10 | $4,532.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.00 / $442.00 / $442.00
| Facility | | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.96 / $616.66 / $4,510.00
| Facility | | $390.96 | $616.66 | $4,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $2,976.26 / $5,562.00
| Facility | | $1,436.00 | $2,976.26 | $5,562.00 |