- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,184.56 / $4,304.00 / $8,240.00
| Facility | | $1,184.56 | $4,304.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,598.56 / $3,598.56 / $57,291.12
| Facility | | $3,598.56 | $3,598.56 | $57,291.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,761.00 / $8,247.00
| Facility | | $1,020.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.49 / $1,061.01 / $1,061.01
| Facility | | $970.49 | $1,061.01 | $1,061.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |