- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.22 / $3,329.00 / $7,602.00
| Facility | | $1,275.22 | $3,329.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,171.00 / $6,366.00 / $9,272.00
| Facility | | $3,171.00 | $6,366.00 | $9,272.00 |
- 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 / $14,926.05 / $15,270.66
| Facility | | $5,000.00 | $14,926.05 | $15,270.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.00 / $8,273.00 / $12,407.00
| Facility | | $3,964.00 | $8,273.00 | $12,407.00 |