- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.33 / $2,940.93 / $14,063.00
| Facility | | $1,144.33 | $2,940.93 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,146.00 / $10,080.00 / $40,869.00
| Facility | | $4,146.00 | $10,080.00 | $40,869.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.39 / $1,557.98 / $2,336.96
| Facility | | $1,182.39 | $1,557.98 | $2,336.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,024.81 / $19,024.81 / $22,552.05
| Facility | | $19,024.81 | $19,024.81 | $22,552.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |