- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $9,544.15 / $20,928.72
| Facility | | $5,463.36 | $9,544.15 | $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
- $291.22 / $510.66 / $6,451.00
| Facility | | $291.22 | $510.66 | $6,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.72 / $727.03 / $1,813.25
| Facility | | $546.72 | $727.03 | $1,813.25 |
- 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 |