- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.45 / $9,622.00 / $18,276.00
| Facility | | $1,751.45 | $9,622.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,912.64 / $23,962.25 / $42,530.11
| Facility | | $11,912.64 | $23,962.25 | $42,530.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $1,130.00 / $18,064.08
| Facility | | $1,130.00 | $1,130.00 | $18,064.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,206.00 / $1,717.04 / $2,467.94
| Facility | | $1,206.00 | $1,717.04 | $2,467.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $17,146.00 / $24,161.00
| Facility | | $3,437.00 | $17,146.00 | $24,161.00 |