- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,147.66 / $3,983.00 / $10,331.70
| Facility | | $1,147.66 | $3,983.00 | $10,331.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,683.00 / $14,996.00
| Facility | | $1,760.00 | $3,683.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.44 / $958.00 / $1,185.73
| Facility | | $746.44 | $958.00 | $1,185.73 |
- 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
- $956.71 / $1,346.13 / $6,941.00
| Facility | | $956.71 | $1,346.13 | $6,941.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,625.00 / $7,853.00
| Facility | | $2,840.00 | $5,625.00 | $7,853.00 |