- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,158.05 / $5,459.00 / $11,581.00
| Facility | | $1,158.05 | $5,459.00 | $11,581.00 |
- 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
- $661.65 / $793.98 / $982.72
| Facility | | $661.65 | $793.98 | $982.72 |
- 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
- $1,251.96 / $3,611.49 / $3,909.84
| Facility | | $1,251.96 | $3,611.49 | $3,909.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,879.00 / $5,939.27 / $9,483.00
| Facility | | $3,879.00 | $5,939.27 | $9,483.00 |