- 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
- $542.00 / $972.59 / $1,023.78
| Facility | | $542.00 | $972.59 | $1,023.78 |
- 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
- $561.15 / $876.07 / $3,331.00
| Facility | | $561.15 | $876.07 | $3,331.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.00 / $2,081.00 / $3,842.00
| Facility | | $825.00 | $2,081.00 | $3,842.00 |