- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,167.19 / $9,181.42 / $21,466.50
| Facility | | $2,167.19 | $9,181.42 | $21,466.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $7,826.00 / $36,529.00
| Facility | | $2,097.00 | $7,826.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,236.40 / $1,483.68 / $1,836.38
| Facility | | $1,236.40 | $1,483.68 | $1,836.38 |
- 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
- $4,070.00 / $8,448.00 / $13,382.00
| Facility | | $4,070.00 | $8,448.00 | $13,382.00 |