- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,411.00 / $5,244.00 / $8,031.00
| Facility | | $2,411.00 | $5,244.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,905.00 / $36,422.57 / $44,754.00
| Facility | | $12,905.00 | $36,422.57 | $44,754.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737.00 / $39,753.66 / $39,753.66
| Facility | | $737.00 | $39,753.66 | $39,753.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.28 / $5,322.00 / $5,432.00
| Facility | | $5,028.28 | $5,322.00 | $5,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,610.00 / $13,497.00 / $18,110.00
| Facility | | $7,610.00 | $13,497.00 | $18,110.00 |