- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,133.67 / $3,805.43 / $7,602.00
| Facility | | $2,133.67 | $3,805.43 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,014.00 / $6,552.00 / $9,553.00
| Facility | | $3,014.00 | $6,552.00 | $9,553.00 |
- 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 / $22,349.58 / $22,889.35
| Facility | | $5,000.00 | $22,349.58 | $22,889.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,665.00 / $4,918.00
| Facility | | $1,233.00 | $2,665.00 | $4,918.00 |