- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,521.00 / $9,112.00
| Facility | | $1,965.00 | $4,521.00 | $9,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,805.25 / $6,640.00 / $10,860.55
| Facility | | $1,805.25 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,544.38 / $5,544.38 / $5,544.38
| Facility | | $5,544.38 | $5,544.38 | $5,544.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.50 / $992.68 / $9,978.00
| Facility | | $600.50 | $992.68 | $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 |