- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,637.00 / $10,439.00
| Facility | | $1,000.00 | $3,637.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,156.00 / $2,439.85 / $2,943.50
| Facility | | $1,156.00 | $2,439.85 | $2,943.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,690.00 / $9,690.00 / $9,690.00
| Facility | | $9,690.00 | $9,690.00 | $9,690.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.14 / $464.73 / $9,451.00
| Facility | | $250.14 | $464.73 | $9,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,647.00 / $6,988.00
| Facility | | $1,779.00 | $3,647.00 | $6,988.00 |