- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,018.57 / $4,846.00 / $14,483.00
| Facility | | $1,018.57 | $4,846.00 | $14,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.00 / $26,869.00 / $45,778.00
| Facility | | $2,575.00 | $26,869.00 | $45,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.03 / $1,219.74 / $1,407.39
| Facility | | $957.03 | $1,219.74 | $1,407.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,561.47 / $6,561.47 / $6,561.47
| Facility | | $6,561.47 | $6,561.47 | $6,561.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |