- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,333.00 / $4,376.00 / $12,154.00
| Facility | | $1,333.00 | $4,376.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.10 / $2,151.96 / $3,412.16
| Facility | | $1,461.10 | $2,151.96 | $3,412.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $505.00
| Facility | | $505.00 | $505.00 | $505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.72 / $1,365.61 / $3,595.00
| Facility | | $875.72 | $1,365.61 | $3,595.00 |
- 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 |