- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $8,477.27 / $16,762.57
| Facility | | $4,241.22 | $8,477.27 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,422.95 / $4,502.10 / $8,708.54
| Facility | | $3,422.95 | $4,502.10 | $8,708.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.86 / $509.84 / $4,815.00
| Facility | | $234.86 | $509.84 | $4,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.25 / $711.37 / $2,197.38
| Facility | | $360.25 | $711.37 | $2,197.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |