- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,843.00 / $10,439.00
| Facility | | $1,000.00 | $3,843.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.85 / $1,123.33 / $2,365.78
| Facility | | $762.85 | $1,123.33 | $2,365.78 |
- 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
- $459.96 / $721.00 / $5,562.00
| Facility | | $459.96 | $721.00 | $5,562.00 |
- 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 |