- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,928.00 / $16,400.00
| Facility | | $1,346.00 | $4,928.00 | $16,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.71 / $17,815.62 / $28,366.81
| Facility | | $11,271.71 | $17,815.62 | $28,366.81 |
- 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
- $1,553.13 / $2,427.65 / $14,587.03
| Facility | | $1,553.13 | $2,427.65 | $14,587.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $6,980.00 / $13,541.98
| Facility | | $1,851.00 | $6,980.00 | $13,541.98 |