- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,722.57 / $9,496.00 / $12,545.06
| Facility | | $3,722.57 | $9,496.00 | $12,545.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $8,010.00 / $36,529.00
| Facility | | $2,097.00 | $8,010.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,246.30 / $3,246.30 / $4,727.06
| Facility | | $3,246.30 | $3,246.30 | $4,727.06 |
- 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
- $1,480.00 / $3,086.00 / $6,792.00
| Facility | | $1,480.00 | $3,086.00 | $6,792.00 |