- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,766.08 / $9,185.68 / $20,928.72
| Facility | | $4,766.08 | $9,185.68 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,074.79 / $8,806.74 / $15,455.25
| Facility | | $6,074.79 | $8,806.74 | $15,455.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.20 / $365.84 / $684.02
| Facility | | $215.20 | $365.84 | $684.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.56 / $578.02 / $2,440.29
| Facility | | $404.56 | $578.02 | $2,440.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |