- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,095.00 / $4,521.00 / $15,136.00
| Facility | | $2,095.00 | $4,521.00 | $15,136.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,743.20 / $6,508.67 / $11,404.89
| Facility | | $1,743.20 | $6,508.67 | $11,404.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,746.00 / $17,138.00 / $22,327.00
| Facility | | $16,746.00 | $17,138.00 | $22,327.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.67 / $1,338.90 / $12,632.40
| Facility | | $1,040.67 | $1,338.90 | $12,632.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.00 / $9,437.00 / $28,060.00
| Facility | | $1,472.00 | $9,437.00 | $28,060.00 |