- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.50 / $8,477.27 / $20,928.72
| Facility | | $1,134.50 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,463.60 / $34,806.86 / $67,327.71
| Facility | | $26,463.60 | $34,806.86 | $67,327.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.50 / $1,985.38 / $9,696.00
| Facility | | $1,134.50 | $1,985.38 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,465.14 / $2,841.45 / $3,905.40
| Facility | | $1,465.14 | $2,841.45 | $3,905.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |