- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,707.00 / $7,372.86 / $10,565.00
| Facility | | $3,707.00 | $7,372.86 | $10,565.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,098.00 / $16,131.00 / $24,801.00
| Facility | | $12,098.00 | $16,131.00 | $24,801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $23,736.72 / $23,736.72
| Facility | | $1,041.00 | $23,736.72 | $23,736.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,363.21 / $6,595.00 / $6,730.00
| Facility | | $5,363.21 | $6,595.00 | $6,730.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,336.00 / $17,069.00
| Facility | | $6,943.00 | $10,336.00 | $17,069.00 |