- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $4,376.00 / $12,154.00
| Facility | | $1,700.00 | $4,376.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.72 / $310.07 / $651.39
| Facility | | $246.72 | $310.07 | $651.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.32 / $604.35 / $3,125.00
| Facility | | $370.32 | $604.35 | $3,125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,562.00
| Facility | | $1,436.00 | $3,096.00 | $5,562.00 |