- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $4,728.00 / $14,100.00
| Facility | | $1,392.00 | $4,728.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,629.96 / $12,153.92 / $19,405.75
| Facility | | $7,629.96 | $12,153.92 | $19,405.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,184.66 / $2,184.66 / $2,184.66
| Facility | | $2,184.66 | $2,184.66 | $2,184.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,209.68 / $3,365.00 / $9,451.59
| Facility | | $1,209.68 | $3,365.00 | $9,451.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,407.00 / $9,232.95
| Facility | | $1,481.00 | $5,407.00 | $9,232.95 |