- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,225.91 / $4,846.00 / $17,508.25
| Facility | | $1,225.91 | $4,846.00 | $17,508.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,427.00 / $11,294.00 / $22,813.00
| Facility | | $4,427.00 | $11,294.00 | $22,813.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.46 / $1,803.36 / $2,705.04
| Facility | | $1,322.46 | $1,803.36 | $2,705.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,909.74 / $3,909.74 / $3,909.74
| Facility | | $3,909.74 | $3,909.74 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,000.00 / $15,750.00
| Facility | | $4,699.00 | $10,000.00 | $15,750.00 |