- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.76 / $5,194.00 / $10,492.00
| Facility | | $1,079.76 | $5,194.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,678.00 / $35,579.31 / $48,414.52
| Facility | | $9,678.00 | $35,579.31 | $48,414.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $843.00 / $843.00
| Facility | | $843.00 | $843.00 | $843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,346.67 / $2,466.00 / $2,518.00
| Facility | | $2,346.67 | $2,466.00 | $2,518.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,336.00 / $17,069.00
| Facility | | $6,943.00 | $10,336.00 | $17,069.00 |