- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,960.15
| Facility | | $1,671.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,295.20 / $4,835.95 / $8,473.85
| Facility | | $1,295.20 | $4,835.95 | $8,473.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,746.00 / $16,746.00 / $22,327.00
| Facility | | $16,746.00 | $16,746.00 | $22,327.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.55 / $1,130.53 / $9,943.00
| Facility | | $883.55 | $1,130.53 | $9,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $6,336.00 / $28,060.00
| Facility | | $1,424.00 | $6,336.00 | $28,060.00 |