- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $12,029.70 / $24,068.03
| Facility | | $5,463.36 | $12,029.70 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.16 / $12,883.29 / $24,185.23
| Facility | | $9,506.16 | $12,883.29 | $24,185.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.80 / $144.43 / $9,496.00
| Facility | | $89.80 | $144.43 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.84 / $204.85 / $290.94
| Facility | | $164.84 | $204.85 | $290.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |