- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,521.00 / $9,112.00
| Facility | | $1,965.00 | $4,521.00 | $9,112.00 |
- 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
- $1,269.33 / $2,061.36 / $10,694.00
| Facility | | $1,269.33 | $2,061.36 | $10,694.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |