- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.01 / $8,041.15 / $15,575.00
| Facility | | $1,144.01 | $8,041.15 | $15,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,719.00 / $10,700.00 / $19,484.00
| Facility | | $3,719.00 | $10,700.00 | $19,484.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.41 / $875.43 / $1,010.12
| Facility | | $673.41 | $875.43 | $1,010.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,868.68 / $3,868.68 / $3,868.68
| Facility | | $3,868.68 | $3,868.68 | $3,868.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,000.00 / $15,750.00
| Facility | | $4,699.00 | $10,000.00 | $15,750.00 |