- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,737.00 / $8,606.00 / $11,914.00
| Facility | | $2,737.00 | $8,606.00 | $11,914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,344.00 / $4,696.00 / $7,216.00
| Facility | | $1,344.00 | $4,696.00 | $7,216.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,173.00 / $4,464.00 / $5,106.25
| Facility | | $2,173.00 | $4,464.00 | $5,106.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,640.00 / $3,640.00 / $3,640.00
| Facility | | $3,640.00 | $3,640.00 | $3,640.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $1,121.00 / $6,068.00
| Facility | | $700.00 | $1,121.00 | $6,068.00 |