- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $5,706.00 / $10,817.74
| Facility | | $900.00 | $5,706.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,576.00 / $14,996.00
| Facility | | $1,760.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.16 / $671.45 / $891.77
| Facility | | $523.16 | $671.45 | $891.77 |
- 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
- $671.06 / $671.06 / $671.06
| Facility | | $671.06 | $671.06 | $671.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,904.00 / $5,998.00 / $9,245.00
| Facility | | $2,904.00 | $5,998.00 | $9,245.00 |