- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,469.68 / $10,985.00 / $23,519.55
| Facility | | $1,469.68 | $10,985.00 | $23,519.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,841.00 / $36,271.00 / $56,650.00
| Facility | | $3,841.00 | $36,271.00 | $56,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,429.03 / $1,857.74 / $2,143.55
| Facility | | $1,429.03 | $1,857.74 | $2,143.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,769.46 / $18,769.46 / $22,249.35
| Facility | | $18,769.46 | $18,769.46 | $22,249.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,649.00
| Facility | | $5,058.00 | $12,330.00 | $17,649.00 |