- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,177.86 / $16,042.00 / $29,292.48
| Facility | | $1,177.86 | $16,042.00 | $29,292.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $16,700.00 / $33,821.32
| Facility | | $4,008.00 | $16,700.00 | $33,821.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,169.63 / $1,605.38 / $2,408.07
| Facility | | $1,169.63 | $1,605.38 | $2,408.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,330.00 / $17,416.00
| Facility | | $5,431.00 | $12,330.00 | $17,416.00 |