- 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
- $3,896.29 / $5,280.48 / $9,912.79
| Facility | | $3,896.29 | $5,280.48 | $9,912.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.83 / $891.84 / $7,772.00
| Facility | | $505.83 | $891.84 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.43 / $1,269.99 / $3,145.09
| Facility | | $953.43 | $1,269.99 | $3,145.09 |
- 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 |