- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.86 / $10,555.14 / $15,926.42
| Facility | | $964.86 | $10,555.14 | $15,926.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,321.00 / $7,890.00 / $21,000.00
| Facility | | $3,321.00 | $7,890.00 | $21,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $943.58 / $1,374.40 / $1,480.12
| Facility | | $943.58 | $1,374.40 | $1,480.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,594.87 / $3,594.87 / $3,594.87
| Facility | | $3,594.87 | $3,594.87 | $3,594.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,000.00 / $15,750.00
| Facility | | $4,699.00 | $10,000.00 | $15,750.00 |