- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.62 / $927.62 / $7,212.00
| Facility | | $623.62 | $927.62 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,796.00 / $6,340.00 / $15,727.00
| Facility | | $2,796.00 | $6,340.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $583.76 / $744.00 / $1,067.03
| Facility | | $583.76 | $744.00 | $1,067.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,909.74 / $3,909.74 / $3,909.74
| Facility | | $3,909.74 | $3,909.74 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |