- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.06 / $4,447.80 / $11,627.00
| Facility | | $1,393.06 | $4,447.80 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $6,934.00 / $30,285.00
| Facility | | $2,777.00 | $6,934.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $917.21 / $1,177.18 / $1,563.44
| Facility | | $917.21 | $1,177.18 | $1,563.44 |
- 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
- $1,171.73 / $2,635.41 / $5,332.71
| Facility | | $1,171.73 | $2,635.41 | $5,332.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,676.00
| Facility | | $4,070.00 | $8,440.00 | $13,676.00 |