- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,917.00 / $3,596.15 / $5,080.02
| Facility | | $2,917.00 | $3,596.15 | $5,080.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.52 / $86.16 / $3,644.19
| Facility | | $59.52 | $86.16 | $3,644.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,184.00 / $2,184.00 / $2,184.00
| Facility | | $2,184.00 | $2,184.00 | $2,184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.75 / $68.00 / $244.40
| Facility | | $39.75 | $68.00 | $244.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $800.00 / $1,030.00
| Facility | | $425.00 | $800.00 | $1,030.00 |