- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,522.00 / $7,360.00 / $10,565.00
| Facility | | $3,522.00 | $7,360.00 | $10,565.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,098.00 / $14,528.00 / $17,206.00
| Facility | | $12,098.00 | $14,528.00 | $17,206.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $9,619.46 / $9,619.46
| Facility | | $1,041.00 | $9,619.46 | $9,619.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,302.00 / $4,390.00 / $4,645.51
| Facility | | $4,302.00 | $4,390.00 | $4,645.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,325.00 / $7,843.00 / $11,880.00
| Facility | | $5,325.00 | $7,843.00 | $11,880.00 |