- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,946.00 / $17,600.00
| Facility | | $1,200.00 | $5,946.00 | $17,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,628.16 / $30,959.35 / $49,267.55
| Facility | | $19,628.16 | $30,959.35 | $49,267.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,516.00 / $5,516.00 / $15,917.00
| Facility | | $5,516.00 | $5,516.00 | $15,917.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.50 / $4,134.00 / $18,306.57
| Facility | | $606.50 | $4,134.00 | $18,306.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,570.00 / $7,307.00 / $18,862.37
| Facility | | $1,570.00 | $7,307.00 | $18,862.37 |