- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.04 / $2,860.68 / $16,467.00
| Facility | | $1,244.04 | $2,860.68 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,544.68 / $7,544.68 / $7,544.68
| Facility | | $7,544.68 | $7,544.68 | $7,544.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.56 / $1,280.76 / $2,126.32
| Facility | | $1,076.56 | $1,280.76 | $2,126.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |