- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,464.75 / $5,467.00 / $12,237.00
| Facility | | $1,464.75 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.20 / $1,620.02 / $3,268.77
| Facility | | $1,098.20 | $1,620.02 | $3,268.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,510.00 / $25,510.00 / $25,510.00
| Facility | | $25,510.00 | $25,510.00 | $25,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.79 / $1,545.02 / $16,026.00
| Facility | | $630.79 | $1,545.02 | $16,026.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,647.00 / $6,988.00
| Facility | | $1,779.00 | $3,647.00 | $6,988.00 |