- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,016.00 / $13,151.00
| Facility | | $3,000.00 | $7,016.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,441.00 / $3,708.38 / $4,475.79
| Facility | | $1,441.00 | $3,708.38 | $4,475.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.00 / $2,199.00 / $9,647.00
| Facility | | $1,284.00 | $2,199.00 | $9,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.28 / $831.40 / $5,273.00
| Facility | | $623.28 | $831.40 | $5,273.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,195.00 / $3,277.00 / $7,058.12
| Facility | | $1,195.00 | $3,277.00 | $7,058.12 |