- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,628.54 / $3,746.99 / $16,467.00
| Facility | | $1,628.54 | $3,746.99 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,500.00 / $9,339.07 / $16,855.89
| Facility | | $2,500.00 | $9,339.07 | $16,855.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.18 / $1,628.54 / $2,789.81
| Facility | | $1,248.18 | $1,628.54 | $2,789.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.00 / $15,451.00 / $23,485.00
| Facility | | $990.00 | $15,451.00 | $23,485.00 |