- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,323.00 / $4,309.00 / $5,242.00
| Facility | | $2,323.00 | $4,309.00 | $5,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.62 / $2,264.46 / $3,153.68
| Facility | | $1,447.62 | $2,264.46 | $3,153.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $18.00 / $45.00
| Facility | | $12.00 | $18.00 | $45.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.00 / $3,774.00 / $6,590.00
| Facility | | $1,698.00 | $3,774.00 | $6,590.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,360.45 / $1,816.96 / $2,458.31
| Facility | | $1,360.45 | $1,816.96 | $2,458.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $2,908.00 / $5,892.00
| Facility | | $1,700.00 | $2,908.00 | $5,892.00 |