- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,043.33 / $11,093.00 / $24,064.99
| Facility | | $1,043.33 | $11,093.00 | $24,064.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.00 / $7,890.00 / $37,919.46
| Facility | | $3,065.00 | $7,890.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.66 / $1,417.37 / $2,126.06
| Facility | | $1,032.66 | $1,417.37 | $2,126.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,738.32 / $11,738.32 / $13,914.63
| Facility | | $11,738.32 | $11,738.32 | $13,914.63 |
- 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 |