- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $551.00 / $3,733.00 / $7,237.00
| Facility | | $551.00 | $3,733.00 | $7,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,980.00 / $22,930.43 / $22,930.43
| Facility | | $1,980.00 | $22,930.43 | $22,930.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.00 / $2,742.00 / $5,408.00
| Facility | | $1,100.00 | $2,742.00 | $5,408.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,498.00 / $13,383.00 / $13,383.00
| Facility | | $6,498.00 | $13,383.00 | $13,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,000.00 / $5,592.00
| Facility | | $900.00 | $2,000.00 | $5,592.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $1,000.00 / $2,460.00
| Facility | | $450.00 | $1,000.00 | $2,460.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,800.00 / $4,800.00 / $4,800.00
| Facility | | $4,800.00 | $4,800.00 | $4,800.00 |