- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,048.69 / $5,487.01 / $10,300.52
| Facility | | $4,048.69 | $5,487.01 | $10,300.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.33 / $774.71 / $7,772.00
| Facility | | $438.33 | $774.71 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.94 / $1,038.17 / $3,145.09
| Facility | | $825.94 | $1,038.17 | $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 |