- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,074.00 / $4,450.00 / $10,492.00
| Facility | | $2,074.00 | $4,450.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,192.00 / $40,649.86 / $47,823.37
| Facility | | $10,192.00 | $40,649.86 | $47,823.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $843.00 / $843.00
| Facility | | $843.00 | $843.00 | $843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,340.80 / $12,532.00 / $12,786.00
| Facility | | $1,340.80 | $12,532.00 | $12,786.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.00 / $3,075.00 / $6,664.00
| Facility | | $1,380.00 | $3,075.00 | $6,664.00 |