- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $6,329.00
| Facility | | $1,671.00 | $3,617.00 | $6,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,598.50 / $10,860.55
| Facility | | $1,763.75 | $6,598.50 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,049.52 / $3,049.52 / $3,049.52
| Facility | | $3,049.52 | $3,049.52 | $3,049.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493.81 / $709.35 / $3,770.00
| Facility | | $493.81 | $709.35 | $3,770.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.00 / $3,339.00 / $5,838.00
| Facility | | $2,140.00 | $3,339.00 | $5,838.00 |