- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $6,284.00 / $13,151.00
| Facility | | $1,857.00 | $6,284.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,526.05 / $6,817.19 / $8,318.36
| Facility | | $2,526.05 | $6,817.19 | $8,318.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,517.00 / $12,517.00 / $12,517.00
| Facility | | $12,517.00 | $12,517.00 | $12,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.94 / $1,833.54 / $7,310.00
| Facility | | $1,047.94 | $1,833.54 | $7,310.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $11,732.00
| Facility | | $1,967.00 | $4,960.00 | $11,732.00 |