- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $12,029.70 / $24,068.03
| Facility | | $5,463.36 | $12,029.70 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,172.22 / $19,955.61 / $38,600.60
| Facility | | $15,172.22 | $19,955.61 | $38,600.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.08 / $1,462.30 / $9,696.00
| Facility | | $953.08 | $1,462.30 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,483.86 / $1,844.02 / $2,458.98
| Facility | | $1,483.86 | $1,844.02 | $2,458.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |