- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,714.00 / $14,100.00
| Facility | | $1,346.00 | $4,714.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,671.93 / $12,125.94 / $19,307.46
| Facility | | $7,671.93 | $12,125.94 | $19,307.46 |
- 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
- $893.21 / $1,250.49 / $7,077.94
| Facility | | $893.21 | $1,250.49 | $7,077.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,091.00 / $4,054.00 / $7,077.94
| Facility | | $1,091.00 | $4,054.00 | $7,077.94 |