- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.33 / $4,846.00 / $18,729.98
| Facility | | $1,201.33 | $4,846.00 | $18,729.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $20,160.00 / $45,778.00
| Facility | | $1,500.00 | $20,160.00 | $45,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,131.76 / $1,442.44 / $1,664.36
| Facility | | $1,131.76 | $1,442.44 | $1,664.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,429.01
| Facility | | $761.00 | $761.00 | $1,429.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,000.00 / $13,594.00 / $19,477.00
| Facility | | $4,000.00 | $13,594.00 | $19,477.00 |