- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,637.26 / $5,601.00 / $11,627.00
| Facility | | $1,637.26 | $5,601.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,408.00 / $14,299.15 / $25,723.30
| Facility | | $4,408.00 | $14,299.15 | $25,723.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,564.36 / $1,877.23 / $2,493.19
| Facility | | $1,564.36 | $1,877.23 | $2,493.19 |
- 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
- $4,873.00 / $10,707.00 / $15,469.00
| Facility | | $4,873.00 | $10,707.00 | $15,469.00 |