- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.17 / $1,724.55 / $3,335.83
| Facility | | $1,311.17 | $1,724.55 | $3,335.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.64 / $330.18 / $13,787.27
| Facility | | $180.64 | $330.18 | $13,787.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.98 / $425.15 / $10,261.44
| Facility | | $282.98 | $425.15 | $10,261.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |