- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,522.00 / $7,360.00 / $10,492.00
| Facility | | $3,522.00 | $7,360.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,282.00 / $15,501.00 / $20,032.00
| Facility | | $6,282.00 | $15,501.00 | $20,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $24,608.60 / $24,608.60
| Facility | | $1,041.00 | $24,608.60 | $24,608.60 |
- 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 |