- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.48 / $2,133.00 / $7,602.00
| Facility | | $510.48 | $2,133.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.00 / $3,549.00 / $5,878.00
| Facility | | $1,676.00 | $3,549.00 | $5,878.00 |
- 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
- $1,945.05 / $6,817.20 / $12,000.00
| Facility | | $1,945.05 | $6,817.20 | $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 |