- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $5,514.00 / $16,900.00
| Facility | | $1,392.00 | $5,514.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,271.00 / $9,962.39 / $15,740.47
| Facility | | $6,271.00 | $9,962.39 | $15,740.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.78 / $2,545.78 / $2,545.78
| Facility | | $2,545.78 | $2,545.78 | $2,545.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.73 / $653.66 / $7,623.12
| Facility | | $474.73 | $653.66 | $7,623.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,424.00 / $7,077.94
| Facility | | $1,157.00 | $4,424.00 | $7,077.94 |