- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $5,467.00 / $12,292.00
| Facility | | $1,700.00 | $5,467.00 | $12,292.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,113.00 / $3,271.96 / $6,871.99
| Facility | | $1,113.00 | $3,271.96 | $6,871.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,129.00 / $3,052.00 / $3,571.00
| Facility | | $1,129.00 | $3,052.00 | $3,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.62 / $534.53 / $8,280.00
| Facility | | $391.62 | $534.53 | $8,280.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $11,732.00
| Facility | | $1,967.00 | $4,960.00 | $11,732.00 |