- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,797.00 / $5,467.00 / $12,237.00
| Facility | | $1,797.00 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.25 / $3,637.48 / $4,808.05
| Facility | | $1,781.25 | $3,637.48 | $4,808.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,432.00 / $11,432.00 / $11,432.00
| Facility | | $11,432.00 | $11,432.00 | $11,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.19 / $762.49 / $15,451.00
| Facility | | $455.19 | $762.49 | $15,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.00 / $6,170.00 / $12,989.00
| Facility | | $2,269.00 | $6,170.00 | $12,989.00 |