- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.00 / $5,355.00 / $11,471.18
| Facility | | $1,610.00 | $5,355.00 | $11,471.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,528.00 / $14,996.00
| Facility | | $1,712.00 | $3,528.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,180.73 / $1,515.37 / $2,012.61
| Facility | | $1,180.73 | $1,515.37 | $2,012.61 |
- 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
- $1,505.40 / $1,505.40 / $1,505.40
| Facility | | $1,505.40 | $1,505.40 | $1,505.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,223.00 / $6,522.00
| Facility | | $2,233.00 | $4,223.00 | $6,522.00 |