- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,000.00 / $7,265.49 / $11,975.00
| Facility | | $6,000.00 | $7,265.49 | $11,975.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,260.34 / $9,434.43 / $19,844.34
| Facility | | $8,260.34 | $9,434.43 | $19,844.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,422.69 / $8,827.04 / $14,563.14
| Facility | | $5,422.69 | $8,827.04 | $14,563.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $12,612.81
| Facility | | $2,332.00 | $5,310.00 | $12,612.81 |