- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $4,387.00 / $10,439.00
| Facility | | $1,700.00 | $4,387.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.90 / $2,722.10 / $4,532.57
| Facility | | $1,939.90 | $2,722.10 | $4,532.57 |
- 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
- $305.47 / $581.08 / $3,561.00
| Facility | | $305.47 | $581.08 | $3,561.00 |
- 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 |