- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,057.16 / $2,453.00 / $16,042.00
| Facility | | $1,057.16 | $2,453.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,719.00 / $10,700.00 / $17,513.00
| Facility | | $3,719.00 | $10,700.00 | $17,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.71 / $1,555.35 / $2,333.03
| Facility | | $1,101.71 | $1,555.35 | $2,333.03 |
- 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 |