- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,646.85 / $5,404.00 / $10,817.74
| Facility | | $1,646.85 | $5,404.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $6,746.00 / $30,285.00
| Facility | | $2,777.00 | $6,746.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,370.00 / $1,758.28 / $2,335.21
| Facility | | $1,370.00 | $1,758.28 | $2,335.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.75 / $1,748.75 / $1,748.75
| Facility | | $1,748.75 | $1,748.75 | $1,748.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,231.00 / $10,075.00
| Facility | | $3,206.00 | $6,231.00 | $10,075.00 |