- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,746.26 / $7,204.00 / $11,627.00
| Facility | | $1,746.26 | $7,204.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,813.00 / $17,502.61 / $31,496.21
| Facility | | $6,813.00 | $17,502.61 | $31,496.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.19 / $1,488.23 / $1,842.01
| Facility | | $1,240.19 | $1,488.23 | $1,842.01 |
- 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
- $4,636.00 / $8,030.00 / $13,382.00
| Facility | | $4,636.00 | $8,030.00 | $13,382.00 |