- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $5,946.00 / $16,900.00
| Facility | | $1,456.00 | $5,946.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,478.98 / $17,825.49 / $28,011.49
| Facility | | $11,478.98 | $17,825.49 | $28,011.49 |
- 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
- $1,339.45 / $2,099.23 / $12,719.00
| Facility | | $1,339.45 | $2,099.23 | $12,719.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,074.00 / $13,541.98
| Facility | | $1,851.00 | $7,074.00 | $13,541.98 |