- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,930.73 / $7,155.00 / $11,627.00
| Facility | | $1,930.73 | $7,155.00 | $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
- $1,908.25 / $2,081.71 / $3,031.27
| Facility | | $1,908.25 | $2,081.71 | $3,031.27 |
- 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
- $2,428.81 / $2,428.81 / $2,428.81
| Facility | | $2,428.81 | $2,428.81 | $2,428.81 |
- 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 |