- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,984.15 / $6,251.00 / $11,581.00
| Facility | | $1,984.15 | $6,251.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,724.00 / $14,299.15 / $25,723.30
| Facility | | $4,724.00 | $14,299.15 | $25,723.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,265.17 / $1,518.20 / $2,372.19
| Facility | | $1,265.17 | $1,518.20 | $2,372.19 |
- 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
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |