- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $4,897.79 / $17,378.01
| Facility | | $1,949.84 | $4,897.79 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $18,197.01 / $26,302.68
| Facility | | $5,623.41 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,862.09 / $2,089.30
| Facility | | $1,778.28 | $1,862.09 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,090.30 / $3,890.45
| Facility | | $758.58 | $3,090.30 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $9,549.93 / $16,218.10
| Facility | | $4,265.80 | $9,549.93 | $16,218.10 |