- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,527.21 / $11,100.08 / $24,068.03
| Facility | | $2,527.21 | $11,100.08 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,193.47 / $8,393.75 / $15,757.21
| Facility | | $6,193.47 | $8,393.75 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.83 / $1,194.32 / $7,772.00
| Facility | | $664.83 | $1,194.32 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.68 / $1,655.77 / $2,571.84
| Facility | | $1,247.68 | $1,655.77 | $2,571.84 |
- 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 |