- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $5,511.00 / $16,900.00
| Facility | | $1,346.00 | $5,511.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,966.27 / $6,203.47 / $9,729.79
| Facility | | $3,966.27 | $6,203.47 | $9,729.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,937.60 / $1,937.60 / $1,937.60
| Facility | | $1,937.60 | $1,937.60 | $1,937.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.34 / $674.40 / $5,465.00
| Facility | | $421.34 | $674.40 | $5,465.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $2,875.93 / $5,543.93
| Facility | | $884.00 | $2,875.93 | $5,543.93 |