- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.34 / $4,846.00 / $14,063.00
| Facility | | $1,008.34 | $4,846.00 | $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
- $999.75 / $1,372.21 / $2,058.32
| Facility | | $999.75 | $1,372.21 | $2,058.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,036.68 / $12,036.68 / $14,268.31
| Facility | | $12,036.68 | $12,036.68 | $14,268.31 |
- 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 |