- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.45 / $3,742.00 / $18,600.00
| Facility | | $1,337.45 | $3,742.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.76 / $15,004.39 / $23,706.76
| Facility | | $9,444.76 | $15,004.39 | $23,706.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $5,792.00 / $5,792.00
| Facility | | $900.00 | $5,792.00 | $5,792.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,351.84 / $2,167.87 / $14,457.00
| Facility | | $1,351.84 | $2,167.87 | $14,457.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.00 / $10,642.00 / $20,423.23
| Facility | | $3,228.00 | $10,642.00 | $20,423.23 |