- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $2,747.00 / $8,247.00
| Facility | | $1,301.00 | $2,747.00 | $8,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,069.80 / $2,069.80 / $2,069.80
| Facility | | $2,069.80 | $2,069.80 | $2,069.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $4,761.00 / $8,427.00
| Facility | | $1,013.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,069.80 / $2,069.80 / $2,069.80
| Facility | | $2,069.80 | $2,069.80 | $2,069.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.44 / $1,780.81 / $1,780.81
| Facility | | $1,775.44 | $1,780.81 | $1,780.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.00 / $2,391.00 / $6,322.00
| Facility | | $448.00 | $2,391.00 | $6,322.00 |