- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,847.00 / $15,066.50 / $29,766.80
| Facility | | $1,847.00 | $15,066.50 | $29,766.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,968.00 / $14,041.58 / $18,708.00
| Facility | | $5,968.00 | $14,041.58 | $18,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.26 / $3,142.79 / $14,396.33
| Facility | | $1,339.26 | $3,142.79 | $14,396.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,470.00 / $17,856.00 / $30,268.27
| Facility | | $10,470.00 | $17,856.00 | $30,268.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $18,820.49 / $26,779.50
| Facility | | $3,496.00 | $18,820.49 | $26,779.50 |