- 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
- $261.72 / $404.97 / $4,406.00
| Facility | | $261.72 | $404.97 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.46 / $505.82 / $690.79
| Facility | | $411.46 | $505.82 | $690.79 |
- 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 |