- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,564.43 / $3,698.00 / $10,635.00
| Facility | | $1,564.43 | $3,698.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,792.00 / $8,800.00
| Facility | | $1,152.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.65 / $1,656.78 / $2,050.63
| Facility | | $1,380.65 | $1,656.78 | $2,050.63 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |