- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $939.46 / $10,279.15 / $17,221.78
| Facility | | $939.46 | $10,279.15 | $17,221.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,052.00 / $4,832.82 / $10,202.45
| Facility | | $2,052.00 | $4,832.82 | $10,202.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.69 / $816.71 / $1,295.74
| Facility | | $666.69 | $816.71 | $1,295.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.00 / $12,269.00 / $19,591.00
| Facility | | $870.00 | $12,269.00 | $19,591.00 |