- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.62 / $2,011.00 / $7,602.00
| Facility | | $361.62 | $2,011.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $2,142.00 / $2,805.00
| Facility | | $1,275.00 | $2,142.00 | $2,805.00 |
- 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
- $843.20 / $931.19 / $12,000.00
| Facility | | $843.20 | $931.19 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,750.00 / $3,612.00 / $6,285.00
| Facility | | $1,750.00 | $3,612.00 | $6,285.00 |