- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $3,803.00 / $12,600.00
| Facility | | $1,200.00 | $3,803.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,588.83 / $13,547.08 / $21,483.29
| Facility | | $8,588.83 | $13,547.08 | $21,483.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $8,274.00 / $8,274.00
| Facility | | $2,321.00 | $8,274.00 | $8,274.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.98 / $1,583.11 / $16,469.61
| Facility | | $1,120.98 | $1,583.11 | $16,469.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $8,707.00 / $33,741.00
| Facility | | $1,851.00 | $8,707.00 | $33,741.00 |