- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,258.00 / $3,940.00 / $7,602.00
| Facility | | $2,258.00 | $3,940.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.00 / $2,387.00 / $7,178.00
| Facility | | $1,417.00 | $2,387.00 | $7,178.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $30,456.44 / $31,385.48
| Facility | | $5,000.00 | $30,456.44 | $31,385.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,665.00 / $4,918.00
| Facility | | $1,233.00 | $2,665.00 | $4,918.00 |