- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $4,701.01 / $13,841.56
| Facility | | $2,318.31 | $4,701.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,489.78 / $7,958.64 / $13,966.90
| Facility | | $5,489.78 | $7,958.64 | $13,966.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.19 / $758.52 / $1,190.00
| Facility | | $446.19 | $758.52 | $1,190.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.31 / $1,114.68 / $2,516.35
| Facility | | $729.31 | $1,114.68 | $2,516.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |