- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,117.53 / $3,776.64 / $7,602.00
| Facility | | $2,117.53 | $3,776.64 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,984.00 / $6,491.00 / $10,237.00
| Facility | | $2,984.00 | $6,491.00 | $10,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $21,913.76 / $22,572.22
| Facility | | $5,000.00 | $21,913.76 | $22,572.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.00 / $8,222.00 / $12,407.00
| Facility | | $3,964.00 | $8,222.00 | $12,407.00 |