- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,589.09 / $5,194.00 / $10,492.00
| Facility | | $3,589.09 | $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
- $2,346.67 / $2,466.00 / $2,518.00
| Facility | | $2,346.67 | $2,466.00 | $2,518.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,242.00 / $4,647.00 / $9,973.00
| Facility | | $1,242.00 | $4,647.00 | $9,973.00 |