- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.97 / $1,636.55 / $6,681.00
| Facility | | $548.97 | $1,636.55 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,664.00 / $3,611.00 / $5,878.00
| Facility | | $1,664.00 | $3,611.00 | $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
- $2,760.44 / $2,997.39 / $12,000.00
| Facility | | $2,760.44 | $2,997.39 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $2,298.00 / $4,099.00
| Facility | | $1,130.00 | $2,298.00 | $4,099.00 |