- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,784.72 / $9,765.56 / $17,184.59
| Facility | | $5,784.72 | $9,765.56 | $17,184.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,102.00 / $3,102.00 / $3,102.00
| Facility | | $3,102.00 | $3,102.00 | $3,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,741.31 / $8,474.73 / $14,012.50
| Facility | | $5,741.31 | $8,474.73 | $14,012.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,262.10 / $9,001.45 / $12,957.98
| Facility | | $5,262.10 | $9,001.45 | $12,957.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,851.00 / $48,537.00 / $48,537.00
| Facility | | $19,851.00 | $48,537.00 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $9,285.86 / $18,847.00
| Facility | | $2,520.00 | $9,285.86 | $18,847.00 |