- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,424.93 / $17,657.45 / $34,155.21
| Facility | | $13,424.93 | $17,657.45 | $34,155.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.35 / $424.87 / $4,406.00
| Facility | | $270.35 | $424.87 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.52 / $512.37 / $716.44
| Facility | | $424.52 | $512.37 | $716.44 |
- 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 |