- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $4,888.00 / $12,473.00
| Facility | | $2,100.00 | $4,888.00 | $12,473.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.54 / $4,934.39 / $8,070.83
| Facility | | $1,341.54 | $4,934.39 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,382.81 / $11,382.81 / $11,382.81
| Facility | | $11,382.81 | $11,382.81 | $11,382.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.72 / $618.41 / $9,978.00
| Facility | | $379.72 | $618.41 | $9,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |