- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,255.58 / $1,255.58 / $1,255.58
| Facility | | $1,255.58 | $1,255.58 | $1,255.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,297.38 / $24,536.18 / $48,429.15
| Facility | | $14,297.38 | $24,536.18 | $48,429.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,082.69 / $4,371.63 / $10,516.55
| Facility | | $3,082.69 | $4,371.63 | $10,516.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,506.00 / $3,996.72 / $8,280.75
| Facility | | $2,506.00 | $3,996.72 | $8,280.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,726.34 / $2,381.16 / $3,571.74
| Facility | | $1,726.34 | $2,381.16 | $3,571.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |