- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,386.00 / $6,663.42 / $14,103.64
| Facility | | $1,386.00 | $6,663.42 | $14,103.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.00 / $26,904.00 / $47,628.00
| Facility | | $2,575.00 | $26,904.00 | $47,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,490.37 / $1,862.96 / $2,235.56
| Facility | | $1,490.37 | $1,862.96 | $2,235.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,154.03 / $12,154.03 / $14,407.41
| Facility | | $12,154.03 | $12,154.03 | $14,407.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $13,127.00 / $18,302.00
| Facility | | $5,431.00 | $13,127.00 | $18,302.00 |