- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,728.00 / $14,100.00
| Facility | | $1,346.00 | $4,728.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,116.83 / $9,733.03 / $15,488.78
| Facility | | $6,116.83 | $9,733.03 | $15,488.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,571.53 / $3,571.53 / $3,571.53
| Facility | | $3,571.53 | $3,571.53 | $3,571.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,223.14 / $3,365.00 / $10,296.00
| Facility | | $1,223.14 | $3,365.00 | $10,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,258.72 / $9,232.95
| Facility | | $1,481.00 | $5,258.72 | $9,232.95 |