- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.42 / $8,553.00 / $12,096.23
| Facility | | $2,137.42 | $8,553.00 | $12,096.23 |
- 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
- $2,255.75 / $2,706.90 / $4,229.54
| Facility | | $2,255.75 | $2,706.90 | $4,229.54 |
- 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 |