- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,613.51 / $5,706.00 / $11,581.00
| Facility | | $1,613.51 | $5,706.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,541.00 / $7,880.43 / $14,996.00
| Facility | | $3,541.00 | $7,880.43 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.35 / $1,372.19 / $1,472.42
| Facility | | $942.35 | $1,372.19 | $1,472.42 |
- 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 / $7,778.00
| Facility | | $1,480.00 | $3,086.00 | $7,778.00 |