- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,292.00 / $8,279.00 / $12,096.23
| Facility | | $2,292.00 | $8,279.00 | $12,096.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,932.00 / $12,098.50 / $22,852.30
| Facility | | $4,932.00 | $12,098.50 | $22,852.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,726.57 / $2,071.88 / $2,564.41
| Facility | | $1,726.57 | $2,071.88 | $2,564.41 |
- 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
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |