- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,103.90 / $2,924.76 / $16,042.00
| Facility | | $1,103.90 | $2,924.76 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.00 / $10,700.00 / $17,513.00
| Facility | | $4,322.00 | $10,700.00 | $17,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.55 / $1,626.21 / $2,439.32
| Facility | | $1,192.55 | $1,626.21 | $2,439.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,909.74 / $3,909.74 / $3,909.74
| Facility | | $3,909.74 | $3,909.74 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,000.00 / $15,750.00
| Facility | | $4,699.00 | $10,000.00 | $15,750.00 |