- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.42 / $5,597.00 / $10,817.74
| Facility | | $1,232.42 | $5,597.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,792.00 / $8,800.00
| Facility | | $1,145.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.10 / $1,633.94 / $1,633.94
| Facility | | $1,122.10 | $1,633.94 | $1,633.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,689.00 / $2,551.00 / $5,235.00
| Facility | | $1,689.00 | $2,551.00 | $5,235.00 |