- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $20,928.72
| Facility | | $5,463.36 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,503.12 / $7,458.15 / $14,000.85
| Facility | | $5,503.12 | $7,458.15 | $14,000.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.43 / $628.14 / $7,772.00
| Facility | | $351.43 | $628.14 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.78 / $885.20 / $3,054.91
| Facility | | $662.78 | $885.20 | $3,054.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,483.00 / $7,934.00
| Facility | | $3,711.00 | $5,483.00 | $7,934.00 |