- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,323.57 / $8,956.00 / $32,703.27
| Facility | | $2,323.57 | $8,956.00 | $32,703.27 |
- 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
- $2,434.28 / $2,955.53 / $3,658.11
| Facility | | $2,434.28 | $2,955.53 | $3,658.11 |
- 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
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |