- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,606.00 / $10,635.00
| Facility | | $1,000.00 | $2,606.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,861.00 / $3,554.00 / $19,117.00
| Facility | | $1,861.00 | $3,554.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $743.99 / $892.79 / $1,105.03
| Facility | | $743.99 | $892.79 | $1,105.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,874.00 / $6,111.00 / $7,853.00
| Facility | | $2,874.00 | $6,111.00 | $7,853.00 |