- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,165.00 / $3,117.00 / $8,366.00
| Facility | | $1,165.00 | $3,117.00 | $8,366.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.56 / $371.55 / $1,617.11
| Facility | | $30.56 | $371.55 | $1,617.11 |
- 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
- $479.00 / $812.00 / $2,229.00
| Facility | | $479.00 | $812.00 | $2,229.00 |