- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.86 / $6,735.00 / $17,999.00
| Facility | | $1,110.86 | $6,735.00 | $17,999.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $518.28 / $35,600.00
| Facility | | $0.71 | $518.28 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.86 / $1,388.03 / $1,975.41
| Facility | | $1,110.86 | $1,388.03 | $1,975.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,717.00 / $2,500.00 / $19,832.00
| Facility | | $1,717.00 | $2,500.00 | $19,832.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,632.40 / $18,000.00 / $32,472.55
| Facility | | $12,632.40 | $18,000.00 | $32,472.55 |