- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.92 / $5,135.00 / $10,817.74
| Facility | | $1,014.92 | $5,135.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,443.00 / $8,800.00
| Facility | | $1,145.00 | $2,443.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.78 / $916.08 / $1,133.83
| Facility | | $713.78 | $916.08 | $1,133.83 |
- 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
- $911.36 / $911.36 / $911.36
| Facility | | $911.36 | $911.36 | $911.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $1,009.00 / $3,398.00
| Facility | | $480.00 | $1,009.00 | $3,398.00 |