- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,106.68 / $6,571.00 / $11,059.01
| Facility | | $3,106.68 | $6,571.00 | $11,059.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,407.00 / $16,131.00 / $31,731.00
| Facility | | $8,407.00 | $16,131.00 | $31,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $27,003.08 / $27,003.08
| Facility | | $1,041.00 | $27,003.08 | $27,003.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,363.21 / $6,595.00 / $6,730.00
| Facility | | $5,363.21 | $6,595.00 | $6,730.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,003.10 / $12,003.10 / $12,003.10
| Facility | | $12,003.10 | $12,003.10 | $12,003.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,348.00 / $18,470.00
| Facility | | $6,943.00 | $10,348.00 | $18,470.00 |