- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,900.34 / $5,194.00 / $10,492.00
| Facility | | $1,900.34 | $5,194.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,678.00 / $50,852.12 / $69,197.00
| Facility | | $9,678.00 | $50,852.12 | $69,197.00 |
- 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
- $2,346.67 / $2,466.00 / $2,518.00
| Facility | | $2,346.67 | $2,466.00 | $2,518.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,838.00 / $14,587.00 / $21,600.00
| Facility | | $8,838.00 | $14,587.00 | $21,600.00 |