- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,381.54 / $7,218.00 / $12,313.00
| Facility | | $1,381.54 | $7,218.00 | $12,313.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,895.00 / $6,080.00 / $29,406.00
| Facility | | $1,895.00 | $6,080.00 | $29,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $864.15 / $1,036.98 / $1,620.29
| Facility | | $864.15 | $1,036.98 | $1,620.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,578.00 / $10,075.00
| Facility | | $3,206.00 | $6,578.00 | $10,075.00 |