- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,379.16 / $4,846.00 / $24,827.04
| Facility | | $1,379.16 | $4,846.00 | $24,827.04 |
- 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
- $1,443.34 / $2,037.65 / $3,056.48
| Facility | | $1,443.34 | $2,037.65 | $3,056.48 |
- 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 |