- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.39 / $5,608.16 / $10,817.74
| Facility | | $1,031.39 | $5,608.16 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,134.00 / $8,010.00 / $36,529.00
| Facility | | $2,134.00 | $8,010.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.36 / $739.61 / $925.09
| Facility | | $582.36 | $739.61 | $925.09 |
- 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
- $749.68 / $749.68 / $3,542.96
| Facility | | $749.68 | $749.68 | $3,542.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,873.00 / $10,707.00 / $16,745.00
| Facility | | $4,873.00 | $10,707.00 | $16,745.00 |