- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $3,785.00 / $7,467.00
| Facility | | $1,965.00 | $3,785.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,515.38 / $4,140.09
| Facility | | $672.35 | $2,515.38 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.10 / $4,100.10 / $4,100.10
| Facility | | $4,100.10 | $4,100.10 | $4,100.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.18 / $491.00 / $3,787.00
| Facility | | $358.18 | $491.00 | $3,787.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.00 / $3,592.00 / $5,546.00
| Facility | | $2,140.00 | $3,592.00 | $5,546.00 |