- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.38 / $4,192.00 / $13,200.00
| Facility | | $1,350.38 | $4,192.00 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,301.33 / $17,825.49 / $28,268.11
| Facility | | $11,301.33 | $17,825.49 | $28,268.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.01 / $1,768.75 / $14,100.00
| Facility | | $1,249.01 | $1,768.75 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.00 / $10,642.00 / $20,423.23
| Facility | | $3,228.00 | $10,642.00 | $20,423.23 |