- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,847.00 / $13,201.80 / $26,082.70
| Facility | | $1,847.00 | $13,201.80 | $26,082.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,222.00 / $13,474.24 / $22,069.77
| Facility | | $6,222.00 | $13,474.24 | $22,069.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.26 / $3,142.79 / $13,951.39
| Facility | | $1,339.26 | $3,142.79 | $13,951.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,470.00 / $17,512.00 / $26,522.09
| Facility | | $10,470.00 | $17,512.00 | $26,522.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,363.02 / $23,465.11
| Facility | | $3,496.00 | $15,363.02 | $23,465.11 |