- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.00 / $5,135.00 / $10,817.74
| Facility | | $1,610.00 | $5,135.00 | $10,817.74 |
- 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
- $1,038.50 / $1,332.83 / $1,770.17
| Facility | | $1,038.50 | $1,332.83 | $1,770.17 |
- 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
- $1,324.34 / $1,324.34 / $1,324.34
| Facility | | $1,324.34 | $1,324.34 | $1,324.34 |
- 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 |