- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,181.00 / $16,124.77 / $33,325.80
| Facility | | $5,181.00 | $16,124.77 | $33,325.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,434.58 / $9,916.15 / $13,400.44
| Facility | | $7,434.58 | $9,916.15 | $13,400.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,867.00 / $9,868.39 / $17,361.58
| Facility | | $1,867.00 | $9,868.39 | $17,361.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.52 / $16,606.83 / $37,062.80
| Facility | | $1,474.52 | $16,606.83 | $37,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.00 / $10,173.37 / $24,435.00
| Facility | | $428.00 | $10,173.37 | $24,435.00 |