- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,502.00 / $8,522.00 / $20,952.00
| Facility | | $1,502.00 | $8,522.00 | $20,952.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,320.63 / $1,320.63 / $1,320.63
| Facility | | $1,320.63 | $1,320.63 | $1,320.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $2,777.00 / $5,904.00
| Facility | | $1,300.00 | $2,777.00 | $5,904.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.00 / $711.00 / $2,300.00
| Facility | | $434.00 | $711.00 | $2,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $194.36 / $2,855.97
| Facility | | $6.50 | $194.36 | $2,855.97 |