- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $3,742.00 / $18,600.00
| Facility | | $1,346.00 | $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
- $1,672.39 / $2,711.43 / $16,105.41
| Facility | | $1,672.39 | $2,711.43 | $16,105.41 |
- 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 |