- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,170.19 / $3,870.56 / $7,602.00
| Facility | | $2,170.19 | $3,870.56 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,017.00 / $8,156.00 / $13,734.00
| Facility | | $4,017.00 | $8,156.00 | $13,734.00 |
- 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 / $22,619.74 / $23,051.71
| Facility | | $5,000.00 | $22,619.74 | $23,051.71 |
- 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 |