- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,824.00 / $4,069.00 / $10,746.00
| Facility | | $1,824.00 | $4,069.00 | $10,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $2,197.00 / $4,372.00
| Facility | | $1,031.00 | $2,197.00 | $4,372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $525.00 / $2,277.00
| Facility | | $500.00 | $525.00 | $2,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $13,430.08 / $13,701.52
| Facility | | $55.00 | $13,430.08 | $13,701.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,397.00 / $4,544.00
| Facility | | $875.00 | $2,397.00 | $4,544.00 |