- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.68 / $787.00 / $5,320.00
| Facility | | $479.68 | $787.00 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $10,683.00
| Facility | | $1,041.00 | $2,067.00 | $10,683.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.47 / $782.00 / $977.50
| Facility | | $540.47 | $782.00 | $977.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $685.61 / $685.61 / $685.61
| Facility | | $685.61 | $685.61 | $685.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $16,426.00 / $44,783.00
| Facility | | $3,000.00 | $16,426.00 | $44,783.00 |