- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,277.34 / $9,047.15 / $16,467.00
| Facility | | $1,277.34 | $9,047.15 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,993.96 / $18,730.91 / $34,857.08
| Facility | | $6,993.96 | $18,730.91 | $34,857.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $1,100.00 / $10,845.55
| Facility | | $715.00 | $1,100.00 | $10,845.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,236.10 / $1,482.00 / $2,456.25
| Facility | | $1,236.10 | $1,482.00 | $2,456.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |