- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,562.00 / $3,884.00
| Facility | | $900.00 | $2,562.00 | $3,884.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,744.54 / $7,317.22 / $10,655.65
| Facility | | $3,744.54 | $7,317.22 | $10,655.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $850.16 / $850.16
| Facility | | $40.00 | $850.16 | $850.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $675.00 / $1,100.00
| Facility | | $488.00 | $675.00 | $1,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,261.00 / $7,168.00
| Facility | | $385.00 | $1,261.00 | $7,168.00 |