- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.75 / $2,058.54 / $13,043.49
| Facility | | $1,019.75 | $2,058.54 | $13,043.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,104.00 / $5,280.00 / $12,190.00
| Facility | | $3,104.00 | $5,280.00 | $12,190.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,127.68 / $1,547.78 / $1,785.49
| Facility | | $1,127.68 | $1,547.78 | $1,785.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,357.34 / $1,371.61 / $1,371.61
| Facility | | $1,357.34 | $1,371.61 | $1,371.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $21,655.00 / $52,293.00
| Facility | | $3,000.00 | $21,655.00 | $52,293.00 |