- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,142.26 / $6,582.00 / $11,627.00
| Facility | | $1,142.26 | $6,582.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,129.00 / $14,299.15 / $25,723.30
| Facility | | $5,129.00 | $14,299.15 | $25,723.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,074.07 / $1,288.88 / $1,595.27
| Facility | | $1,074.07 | $1,288.88 | $1,595.27 |
- 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 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |