- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,042.03 / $19,276.96
| Facility | | $4,083.97 | $8,042.03 | $19,276.96 |
- 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
- $366.59 / $641.53 / $1,079.44
| Facility | | $366.59 | $641.53 | $1,079.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $813.83 / $1,178.30 / $2,360.86
| Facility | | $813.83 | $1,178.30 | $2,360.86 |
- 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 |