- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $9,640.26 / $16,762.57
| Facility | | $4,382.00 | $9,640.26 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.46 / $5,901.02 / $10,355.91
| Facility | | $4,070.46 | $5,901.02 | $10,355.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.16 / $299.14 / $524.87
| Facility | | $156.16 | $299.14 | $524.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.02 / $581.10 / $2,360.86
| Facility | | $363.02 | $581.10 | $2,360.86 |
- 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 |