- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,611.47 / $24,068.03
| Facility | | $5,463.36 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,828.69 / $16,873.23 / $32,638.27
| Facility | | $12,828.69 | $16,873.23 | $32,638.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.97 / $913.07 / $17,434.59
| Facility | | $538.97 | $913.07 | $17,434.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $1,265.52 / $15,178.52
| Facility | | $842.00 | $1,265.52 | $15,178.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |