- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,072.96 / $5,072.00 / $11,581.00
| Facility | | $1,072.96 | $5,072.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $7,398.00 / $36,529.00
| Facility | | $2,097.00 | $7,398.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.07 / $848.42 / $1,126.82
| Facility | | $661.07 | $848.42 | $1,126.82 |
- 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
- $845.53 / $845.53 / $845.53
| Facility | | $845.53 | $845.53 | $845.53 |
- 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 |