- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $5,511.00 / $16,900.00
| Facility | | $1,392.00 | $5,511.00 | $16,900.00 |
- 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
- $1,070.33 / $2,593.98 / $14,139.00
| Facility | | $1,070.33 | $2,593.98 | $14,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,940.00 / $8,835.00 / $14,587.03
| Facility | | $1,940.00 | $8,835.00 | $14,587.03 |