- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,076.05 / $9,320.67 / $57,000.00
| Facility | | $3,076.05 | $9,320.67 | $57,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $8,010.00 / $36,529.00
| Facility | | $2,097.00 | $8,010.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,682.53 / $2,682.53 / $3,906.13
| Facility | | $2,682.53 | $2,682.53 | $3,906.13 |
- 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 / $6,792.00
| Facility | | $1,480.00 | $3,086.00 | $6,792.00 |