- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $6,072.00 / $11,581.00
| Facility | | $1,000.00 | $6,072.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,202.00 / $5,480.00 / $25,522.00
| Facility | | $2,202.00 | $5,480.00 | $25,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.00 / $808.80 / $1,001.07
| Facility | | $674.00 | $808.80 | $1,001.07 |
- 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
- $10,361.35 / $10,361.35 / $10,361.35
| Facility | | $10,361.35 | $10,361.35 | $10,361.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,448.00 / $13,382.00
| Facility | | $4,070.00 | $8,448.00 | $13,382.00 |