- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,522.00 / $7,360.00 / $10,613.33
| Facility | | $3,522.00 | $7,360.00 | $10,613.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,483.00 / $17,206.00 / $29,890.00
| Facility | | $8,483.00 | $17,206.00 | $29,890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $26,571.87 / $26,571.87
| Facility | | $1,041.00 | $26,571.87 | $26,571.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,363.21 / $6,595.00 / $6,730.00
| Facility | | $5,363.21 | $6,595.00 | $6,730.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,336.00 / $17,069.00
| Facility | | $6,943.00 | $10,336.00 | $17,069.00 |