- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,027.05 / $1,527.22 / $3,749.98
| Facility | | $1,027.05 | $1,527.22 | $3,749.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,121.00 / $2,786.00 / $8,800.00
| Facility | | $1,121.00 | $2,786.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.55 / $1,112.23 / $1,619.56
| Facility | | $1,019.55 | $1,112.23 | $1,619.56 |
- 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
- $1,291.78 / $1,291.78 / $1,291.78
| Facility | | $1,291.78 | $1,291.78 | $1,291.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |