- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,212.00 / $13,686.00
| Facility | | $1,000.00 | $3,212.00 | $13,686.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,151.22 / $35,784.67 / $49,471.75
| Facility | | $20,151.22 | $35,784.67 | $49,471.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,406.15 / $22,406.15 / $22,406.15
| Facility | | $22,406.15 | $22,406.15 | $22,406.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.00 / $5,948.00 / $5,948.00
| Facility | | $5,948.00 | $5,948.00 | $5,948.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $10,381.00 / $26,202.00
| Facility | | $1,200.00 | $10,381.00 | $26,202.00 |