- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,274.00 / $4,470.00 / $10,439.00
| Facility | | $1,274.00 | $4,470.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,433.37 / $1,644.16 / $1,686.32
| Facility | | $1,433.37 | $1,644.16 | $1,686.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $1,516.00 / $1,781.00
| Facility | | $800.00 | $1,516.00 | $1,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.32 / $573.07 / $4,423.00
| Facility | | $391.32 | $573.07 | $4,423.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.00 / $3,096.00 / $5,562.00
| Facility | | $1,037.00 | $3,096.00 | $5,562.00 |