- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.00 / $21,710.50 / $49,346.70
| Facility | | $1,610.00 | $21,710.50 | $49,346.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.00 / $10,178.50 / $26,664.33
| Facility | | $424.00 | $10,178.50 | $26,664.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,727.00 / $17,090.91 / $34,978.83
| Facility | | $1,727.00 | $17,090.91 | $34,978.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,136.17 / $9,597.78 / $38,887.01
| Facility | | $2,136.17 | $9,597.78 | $38,887.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.00 / $6,289.00 / $32,911.08
| Facility | | $1,850.00 | $6,289.00 | $32,911.08 |