- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,254.63 / $7,120.36 / $20,928.72
| Facility | | $2,254.63 | $7,120.36 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,732.29 / $13,189.77 / $24,760.56
| Facility | | $9,732.29 | $13,189.77 | $24,760.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.52 / $719.64 / $7,934.00
| Facility | | $402.52 | $719.64 | $7,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.85 / $1,019.33 / $4,791.04
| Facility | | $763.85 | $1,019.33 | $4,791.04 |
- 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 |