- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.92 / $3,548.16 / $11,208.69
| Facility | | $1,141.92 | $3,548.16 | $11,208.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.00 / $28,631.00 / $47,628.00
| Facility | | $2,575.00 | $28,631.00 | $47,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,113.34 / $1,447.36 / $1,670.03
| Facility | | $1,113.34 | $1,447.36 | $1,670.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,029.78 / $12,029.78 / $14,260.13
| Facility | | $12,029.78 | $12,029.78 | $14,260.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $13,127.00 / $17,649.00
| Facility | | $5,431.00 | $13,127.00 | $17,649.00 |