- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,383.16 / $6,497.00 / $18,068.41
| Facility | | $1,383.16 | $6,497.00 | $18,068.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,023.00 / $24,040.00 / $31,898.00
| Facility | | $16,023.00 | $24,040.00 | $31,898.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $946.35 / $1,241.00 / $2,043.92
| Facility | | $946.35 | $1,241.00 | $2,043.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,077.00 / $26,232.00 / $43,834.00
| Facility | | $12,077.00 | $26,232.00 | $43,834.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,713.11 / $9,713.11 / $14,555.00
| Facility | | $9,713.11 | $9,713.11 | $14,555.00 |