- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $3,426.00 / $8,366.00
| Facility | | $1,350.00 | $3,426.00 | $8,366.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.24 / $372.55 / $1,624.43
| Facility | | $30.24 | $372.55 | $1,624.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,374.00 / $2,114.23 / $5,020.01
| Facility | | $1,374.00 | $2,114.23 | $5,020.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,034.00 / $10,000.00 / $10,000.00
| Facility | | $5,034.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.00 / $674.00 / $1,895.00
| Facility | | $370.00 | $674.00 | $1,895.00 |