- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $7,365.00 / $14,498.00
| Facility | | $1,700.00 | $7,365.00 | $14,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,241.55 / $19,458.36 / $31,845.80
| Facility | | $3,241.55 | $19,458.36 | $31,845.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $8,996.00 / $8,996.00
| Facility | | $624.00 | $8,996.00 | $8,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.54 / $1,331.87 / $20,000.00
| Facility | | $841.54 | $1,331.87 | $20,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,729.00 / $10,400.00 / $34,727.00
| Facility | | $2,729.00 | $10,400.00 | $34,727.00 |