- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $4,728.00 / $14,100.00
| Facility | | $1,456.00 | $4,728.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,212.16 / $14,674.25 / $23,429.85
| Facility | | $9,212.16 | $14,674.25 | $23,429.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,655.49 / $1,655.49 / $1,655.49
| Facility | | $1,655.49 | $1,655.49 | $1,655.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,571.00 / $2,709.00 / $8,198.00
| Facility | | $1,571.00 | $2,709.00 | $8,198.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,424.00 / $8,608.00
| Facility | | $1,157.00 | $4,424.00 | $8,608.00 |