- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,352.23 / $8,455.00 / $11,627.00
| Facility | | $1,352.23 | $8,455.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,920.00 / $15,493.10 / $29,406.00
| Facility | | $5,920.00 | $15,493.10 | $29,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.64 / $1,767.17 / $2,761.20
| Facility | | $1,472.64 | $1,767.17 | $2,761.20 |
- 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
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |