- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,357.32 / $5,201.00 / $11,627.00
| Facility | | $1,357.32 | $5,201.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,287.00 / $7,946.96 / $14,996.00
| Facility | | $3,287.00 | $7,946.96 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.63 / $1,072.46 / $1,424.37
| Facility | | $835.63 | $1,072.46 | $1,424.37 |
- 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
- $1,065.64 / $1,065.64 / $1,065.64
| Facility | | $1,065.64 | $1,065.64 | $1,065.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,625.00 / $7,847.00
| Facility | | $2,840.00 | $5,625.00 | $7,847.00 |