- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.00 / $3,744.73 / $7,602.00
| Facility | | $1,821.00 | $3,744.73 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $2,388.00 / $6,366.00
| Facility | | $1,375.00 | $2,388.00 | $6,366.00 |
- 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 / $15,766.02 / $15,976.53
| Facility | | $5,000.00 | $15,766.02 | $15,976.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,986.00 / $19,168.00
| Facility | | $5,052.00 | $10,986.00 | $19,168.00 |