- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.00 / $2,303.00 / $7,602.00
| Facility | | $582.00 | $2,303.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.00 / $3,753.00 / $5,878.00
| Facility | | $1,676.00 | $3,753.00 | $5,878.00 |
- 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
- $1,120.64 / $11,028.25 / $12,000.00
| Facility | | $1,120.64 | $11,028.25 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,426.00 / $4,722.00 / $7,669.00
| Facility | | $2,426.00 | $4,722.00 | $7,669.00 |