- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.00 / $1,794.00 / $6,681.00
| Facility | | $264.00 | $1,794.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.00 / $3,611.00 / $5,959.00
| Facility | | $1,676.00 | $3,611.00 | $5,959.00 |
- 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
- $1,577.04 / $1,610.52 / $12,000.00
| Facility | | $1,577.04 | $1,610.52 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,791.00 / $4,572.00 / $8,086.00
| Facility | | $2,791.00 | $4,572.00 | $8,086.00 |