- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.77 / $2,303.00 / $6,681.00
| Facility | | $268.77 | $2,303.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $3,457.00 / $5,878.00
| Facility | | $1,565.00 | $3,457.00 | $5,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.00 / $1,754.69 / $2,213.00
| Facility | | $455.00 | $1,754.69 | $2,213.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.98 / $979.98 / $16,394.00
| Facility | | $979.98 | $979.98 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,351.00 / $6,285.00
| Facility | | $1,000.00 | $3,351.00 | $6,285.00 |