- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.00 / $5,135.00 / $10,817.74
| Facility | | $1,610.00 | $5,135.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,470.00 / $16,493.91 / $30,520.67
| Facility | | $4,470.00 | $16,493.91 | $30,520.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.72 / $1,389.26 / $2,170.73
| Facility | | $1,157.72 | $1,389.26 | $2,170.73 |
- 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
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |