- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,992.37 / $8,170.39 / $17,129.02
| Facility | | $1,992.37 | $8,170.39 | $17,129.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,717.57 / $9,602.04 / $16,900.34
| Facility | | $4,717.57 | $9,602.04 | $16,900.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.35 / $1,130.00 / $4,769.93
| Facility | | $845.35 | $1,130.00 | $4,769.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.27 / $1,060.38 / $1,628.08
| Facility | | $822.27 | $1,060.38 | $1,628.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |