- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,652.56 / $7,745.78 / $11,581.00
| Facility | | $1,652.56 | $7,745.78 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,084.00 / $4,437.00 / $19,117.00
| Facility | | $2,084.00 | $4,437.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,118.73 / $1,342.48 / $1,782.98
| Facility | | $1,118.73 | $1,342.48 | $1,782.98 |
- 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
- $3,206.00 / $6,578.00 / $10,075.00
| Facility | | $3,206.00 | $6,578.00 | $10,075.00 |