- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.00 / $6,016.00 / $17,600.00
| Facility | | $1,248.00 | $6,016.00 | $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
- $790.95 / $6,245.00 / $23,845.11
| Facility | | $790.95 | $6,245.00 | $23,845.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,350.00 / $14,254.00 / $24,231.00
| Facility | | $2,350.00 | $14,254.00 | $24,231.00 |