- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,683.00 / $8,400.00
| Facility | | $1,000.00 | $3,683.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,666.79 / $13,768.47 / $21,754.02
| Facility | | $8,666.79 | $13,768.47 | $21,754.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,685.20 / $23,685.20 / $23,685.20
| Facility | | $23,685.20 | $23,685.20 | $23,685.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.93 / $436.96 / $9,412.67
| Facility | | $287.93 | $436.96 | $9,412.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,515.00 / $5,973.00 / $10,708.00
| Facility | | $1,515.00 | $5,973.00 | $10,708.00 |