- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.79 / $2,258.00 / $7,602.00
| Facility | | $534.79 | $2,258.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,530.00 / $2,687.00 / $3,710.00
| Facility | | $1,530.00 | $2,687.00 | $3,710.00 |
- 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
- $1,008.32 / $5,246.20 / $12,000.00
| Facility | | $1,008.32 | $5,246.20 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,626.00 / $6,291.00
| Facility | | $1,794.00 | $3,626.00 | $6,291.00 |