- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $4,387.00 / $10,439.00
| Facility | | $1,661.00 | $4,387.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,419.30 / $2,089.51 / $3,392.25
| Facility | | $1,419.30 | $2,089.51 | $3,392.25 |
- 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
- $266.77 / $531.20 / $3,561.00
| Facility | | $266.77 | $531.20 | $3,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,521.00 / $3,125.00 / $5,565.00
| Facility | | $1,521.00 | $3,125.00 | $5,565.00 |