- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,757.77 / $6,582.00 / $11,627.00
| Facility | | $1,757.77 | $6,582.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,794.51 / $17,502.61 / $31,141.30
| Facility | | $6,794.51 | $17,502.61 | $31,141.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,728.91 / $1,886.09 / $2,746.40
| Facility | | $1,728.91 | $1,886.09 | $2,746.40 |
- 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
- $2,218.90 / $2,218.90 / $2,218.90
| Facility | | $2,218.90 | $2,218.90 | $2,218.90 |
- 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 |