- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $3,683.00 / $12,600.00
| Facility | | $1,048.00 | $3,683.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.50 / $12,508.22 / $19,762.84
| Facility | | $7,873.50 | $12,508.22 | $19,762.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,270.36 / $7,270.36 / $7,270.36
| Facility | | $7,270.36 | $7,270.36 | $7,270.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.45 / $941.74 / $14,063.00
| Facility | | $661.45 | $941.74 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,307.00 / $14,587.03
| Facility | | $1,851.00 | $7,307.00 | $14,587.03 |