- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,229.66 / $6,251.00 / $10,381.36
| Facility | | $1,229.66 | $6,251.00 | $10,381.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,084.00 / $5,042.00 / $19,117.00
| Facility | | $2,084.00 | $5,042.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.55 / $879.44 / $1,044.96
| Facility | | $703.55 | $879.44 | $1,044.96 |
- 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
- $1,640.79 / $3,740.15 / $6,872.36
| Facility | | $1,640.79 | $3,740.15 | $6,872.36 |
- 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 |