- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.61 / $1,821.00 / $6,681.00
| Facility | | $365.61 | $1,821.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.00 / $2,554.00 / $3,591.00
| Facility | | $1,172.00 | $2,554.00 | $3,591.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.00 / $1,087.39 / $1,652.00
| Facility | | $340.00 | $1,087.39 | $1,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $906.78 / $906.78 / $12,000.00
| Facility | | $906.78 | $906.78 | $12,000.00 |
- 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 |