- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,824.00 / $3,825.00 / $8,641.00
| Facility | | $1,824.00 | $3,825.00 | $8,641.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.41 / $372.25 / $1,623.16
| Facility | | $30.41 | $372.25 | $1,623.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.00 / $2,114.23 / $4,028.00
| Facility | | $1,474.00 | $2,114.23 | $4,028.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,264.00 / $9,264.00 / $10,000.00
| Facility | | $9,264.00 | $9,264.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $822.00 / $2,441.00
| Facility | | $500.00 | $822.00 | $2,441.00 |