- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.00 / $2,595.69 / $16,042.00
| Facility | | $1,010.00 | $2,595.69 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,310.00 / $10,288.00 / $26,304.00
| Facility | | $2,310.00 | $10,288.00 | $26,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,073.22 / $1,463.48 / $2,195.21
| Facility | | $1,073.22 | $1,463.48 | $2,195.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,909.74 / $3,909.74 / $3,909.74
| Facility | | $3,909.74 | $3,909.74 | $3,909.74 |
- 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 |