- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.18 / $3,027.00 / $10,268.00
| Facility | | $1,051.18 | $3,027.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.00 / $3,555.00 / $19,117.00
| Facility | | $2,003.00 | $3,555.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.76 / $782.11 / $968.02
| Facility | | $651.76 | $782.11 | $968.02 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |