- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $5,946.00 / $10,256.04
| Facility | | $1,300.00 | $5,946.00 | $10,256.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,328.66 / $19,332.08 / $30,159.63
| Facility | | $12,328.66 | $19,332.08 | $30,159.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,659.86 / $5,659.86 / $5,659.86
| Facility | | $5,659.86 | $5,659.86 | $5,659.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,111.59 / $1,537.44 / $14,063.00
| Facility | | $1,111.59 | $1,537.44 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,307.00 / $14,139.00
| Facility | | $1,851.00 | $7,307.00 | $14,139.00 |