- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.67 / $4,846.00 / $17,355.79
| Facility | | $1,233.67 | $4,846.00 | $17,355.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.00 / $9,219.00 / $37,919.46
| Facility | | $3,065.00 | $9,219.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,218.22 / $1,672.06 / $2,508.09
| Facility | | $1,218.22 | $1,672.06 | $2,508.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,043.59 / $12,043.59 / $14,276.49
| Facility | | $12,043.59 | $12,043.59 | $14,276.49 |
- 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 |