- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $5,246.00 / $12,017.00
| Facility | | $1,965.00 | $5,246.00 | $12,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,500.01 / $12,873.60 / $21,056.38
| Facility | | $3,500.01 | $12,873.60 | $21,056.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,008.00 / $11,353.00 / $18,040.00
| Facility | | $8,008.00 | $11,353.00 | $18,040.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,231.13 / $2,000.37 / $10,694.00
| Facility | | $1,231.13 | $2,000.37 | $10,694.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,458.00 / $7,702.00 / $11,396.00
| Facility | | $5,458.00 | $7,702.00 | $11,396.00 |