- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,109.85 / $2,852.34 / $16,042.00
| Facility | | $1,109.85 | $2,852.34 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.00 / $24,214.00 / $45,778.00
| Facility | | $2,575.00 | $24,214.00 | $45,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.34 / $1,511.65 / $2,267.48
| Facility | | $1,101.34 | $1,511.65 | $2,267.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,937.91 / $12,937.91 / $15,336.62
| Facility | | $12,937.91 | $12,937.91 | $15,336.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,290.00 / $14,061.00 / $23,366.00
| Facility | | $6,290.00 | $14,061.00 | $23,366.00 |