- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,956.80 / $10,268.00
| Facility | | $1,000.00 | $5,956.80 | $10,268.00 |
- 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
- $596.80 / $765.95 / $1,017.27
| Facility | | $596.80 | $765.95 | $1,017.27 |
- 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
- $765.17 / $765.17 / $765.17
| Facility | | $765.17 | $765.17 | $765.17 |
- 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 |