- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,618.87 / $5,194.00 / $10,492.00
| Facility | | $2,618.87 | $5,194.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,098.00 / $19,753.83 / $26,880.01
| Facility | | $12,098.00 | $19,753.83 | $26,880.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,212.00 / $15,639.00 / $15,639.00
| Facility | | $2,212.00 | $15,639.00 | $15,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,793.61 / $6,165.00 / $6,291.00
| Facility | | $2,793.61 | $6,165.00 | $6,291.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,838.00 / $14,587.00 / $21,600.00
| Facility | | $8,838.00 | $14,587.00 | $21,600.00 |