- 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
- $30.48 / $372.57 / $1,626.28
| Facility | | $30.48 | $372.57 | $1,626.28 |
- 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 / $819.00 / $2,229.00
| Facility | | $479.00 | $819.00 | $2,229.00 |