- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.00 / $3,506.00 / $10,439.00
| Facility | | $1,361.00 | $3,506.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,722.70 / $3,820.73 / $6,358.63
| Facility | | $2,722.70 | $3,820.73 | $6,358.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $330.00 / $330.00
| Facility | | $330.00 | $330.00 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.37 / $1,169.49 / $5,032.00
| Facility | | $709.37 | $1,169.49 | $5,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $11,732.00
| Facility | | $1,967.00 | $4,960.00 | $11,732.00 |