- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,092.34 / $8,013.10 / $15,499.92
| Facility | | $6,092.34 | $8,013.10 | $15,499.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.65 / $1,430.08 / $5,341.00
| Facility | | $387.65 | $1,430.08 | $5,341.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.33 / $2,008.00 / $3,018.51
| Facility | | $665.33 | $2,008.00 | $3,018.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.94 / $6,178.00 / $8,816.00
| Facility | | $2,453.94 | $6,178.00 | $8,816.00 |