- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,632.84 / $9,062.00 / $18,276.00
| Facility | | $1,632.84 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,783.09 / $10,824.58 / $17,240.66
| Facility | | $4,783.09 | $10,824.58 | $17,240.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,677.66 / $10,619.00 / $14,963.00
| Facility | | $1,677.66 | $10,619.00 | $14,963.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,471.84 / $1,745.00 / $3,141.80
| Facility | | $1,471.84 | $1,745.00 | $3,141.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |