- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,569.00 / $10,439.00
| Facility | | $1,000.00 | $3,569.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.20 / $2,411.69 / $2,793.36
| Facility | | $1,098.20 | $2,411.69 | $2,793.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.00 / $442.00 / $442.00
| Facility | | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.24 / $667.33 / $4,510.00
| Facility | | $409.24 | $667.33 | $4,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $871.00 / $2,902.00 / $5,562.00
| Facility | | $871.00 | $2,902.00 | $5,562.00 |