- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.16 / $4,846.00 / $14,063.00
| Facility | | $1,036.16 | $4,846.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,591.00 / $9,015.00 / $43,260.00
| Facility | | $2,591.00 | $9,015.00 | $43,260.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.92 / $1,417.74 / $2,126.61
| Facility | | $1,032.92 | $1,417.74 | $2,126.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,889.70 / $8,889.70 / $10,537.86
| Facility | | $8,889.70 | $8,889.70 | $10,537.86 |
- 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 |