- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,218.81 / $10,465.26 / $18,365.84
| Facility | | $7,218.81 | $10,465.26 | $18,365.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.71 / $959.85 / $1,344.77
| Facility | | $508.71 | $959.85 | $1,344.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,011.95 / $1,405.93 / $3,523.19
| Facility | | $1,011.95 | $1,405.93 | $3,523.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,854.28 / $6,178.00 / $8,816.00
| Facility | | $2,854.28 | $6,178.00 | $8,816.00 |