- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,426.81 / $12,775.74 / $23,983.33
| Facility | | $9,426.81 | $12,775.74 | $23,983.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.20 / $280.97 / $4,317.00
| Facility | | $172.20 | $280.97 | $4,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.00 / $392.35 / $554.79
| Facility | | $296.00 | $392.35 | $554.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,126.00 / $4,317.00 / $7,856.00
| Facility | | $3,126.00 | $4,317.00 | $7,856.00 |