- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,521.00 / $8,283.00
| Facility | | $1,671.00 | $4,521.00 | $8,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $6,198.03 / $10,860.55
| Facility | | $1,660.00 | $6,198.03 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,411.00 / $5,411.00 / $7,214.00
| Facility | | $5,411.00 | $5,411.00 | $7,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,818.15 / $2,209.79 / $4,285.01
| Facility | | $1,818.15 | $2,209.79 | $4,285.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.00 / $2,572.00 / $14,572.00
| Facility | | $175.00 | $2,572.00 | $14,572.00 |