- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.31 / $2,575.94 / $14,063.00
| Facility | | $1,002.31 | $2,575.94 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.00 / $9,219.00 / $37,919.46
| Facility | | $3,065.00 | $9,219.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $999.02 / $1,371.20 / $2,056.80
| Facility | | $999.02 | $1,371.20 | $2,056.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,063.53 / $12,063.53 / $14,300.13
| Facility | | $12,063.53 | $12,063.53 | $14,300.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $11,803.02 / $17,416.00
| Facility | | $5,431.00 | $11,803.02 | $17,416.00 |