- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,853.00 / $26,096.20 / $47,428.80
| Facility | | $3,853.00 | $26,096.20 | $47,428.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,851.25 / $13,947.50 / $37,662.24
| Facility | | $6,851.25 | $13,947.50 | $37,662.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $3,867.60 / $20,592.43
| Facility | | $1,474.01 | $3,867.60 | $20,592.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $21,322.74 / $34,452.90
| Facility | | $3,054.00 | $21,322.74 | $34,452.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.00 / $20,110.38 / $53,350.92
| Facility | | $1,249.00 | $20,110.38 | $53,350.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $18,638.41 / $42,305.03
| Facility | | $953.00 | $18,638.41 | $42,305.03 |