- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,283.36 / $6,251.00 / $11,581.00
| Facility | | $1,283.36 | $6,251.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,971.00 / $5,836.00 / $30,285.00
| Facility | | $2,971.00 | $5,836.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $792.62 / $1,017.26 / $1,351.05
| Facility | | $792.62 | $1,017.26 | $1,351.05 |
- 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
- $1,016.63 / $1,016.63 / $1,016.63
| Facility | | $1,016.63 | $1,016.63 | $1,016.63 |
- 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 |