- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,847.00 / $13,472.60 / $26,617.70
| Facility | | $1,847.00 | $13,472.60 | $26,617.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,000.00 / $12,039.23 / $18,917.65
| Facility | | $6,000.00 | $12,039.23 | $18,917.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.26 / $3,142.79 / $15,034.22
| Facility | | $1,339.26 | $3,142.79 | $15,034.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,470.00 / $17,512.00 / $27,066.12
| Facility | | $10,470.00 | $17,512.00 | $27,066.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,678.15 / $23,946.43
| Facility | | $3,496.00 | $15,678.15 | $23,946.43 |