- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,745.38 / $8,289.00 / $13,463.00
| Facility | | $1,745.38 | $8,289.00 | $13,463.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,932.00 / $12,098.50 / $22,852.30
| Facility | | $4,932.00 | $12,098.50 | $22,852.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.93 / $1,207.41 / $1,434.66
| Facility | | $965.93 | $1,207.41 | $1,434.66 |
- 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
- $2,840.00 / $5,998.00 / $7,847.00
| Facility | | $2,840.00 | $5,998.00 | $7,847.00 |