- 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
- $474.04 / $623.50 / $1,206.05
| Facility | | $474.04 | $623.50 | $1,206.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.47 / $253.02 / $4,406.00
| Facility | | $160.47 | $253.02 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.78 / $314.14 / $424.12
| Facility | | $252.78 | $314.14 | $424.12 |
- 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 |