- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $8,477.27 / $20,928.72
| Facility | | $5,463.36 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,064.08 / $4,030.10 / $7,795.52
| Facility | | $3,064.08 | $4,030.10 | $7,795.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.11 / $376.23 / $4,406.00
| Facility | | $274.11 | $376.23 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.30 / $535.99 / $752.95
| Facility | | $431.30 | $535.99 | $752.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |