- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.63 / $5,293.39 / $10,635.00
| Facility | | $1,005.63 | $5,293.39 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $8,010.00 / $36,529.00
| Facility | | $2,097.00 | $8,010.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.16 / $787.39 / $974.57
| Facility | | $656.16 | $787.39 | $974.57 |
- 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
- $1,487.02 / $2,378.37 / $5,347.66
| Facility | | $1,487.02 | $2,378.37 | $5,347.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,578.00 / $10,075.00
| Facility | | $3,206.00 | $6,578.00 | $10,075.00 |