- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,310.91 / $5,597.00 / $11,404.44
| Facility | | $1,310.91 | $5,597.00 | $11,404.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,426.00 / $12,098.50 / $21,233.00
| Facility | | $4,426.00 | $12,098.50 | $21,233.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.69 / $1,025.63 / $1,269.44
| Facility | | $854.69 | $1,025.63 | $1,269.44 |
- 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 |