- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,196.00 / $5,463.36 / $13,841.56
| Facility | | $2,196.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,751.95 / $13,216.42 / $24,810.59
| Facility | | $9,751.95 | $13,216.42 | $24,810.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.31 / $1,707.30 / $8,632.00
| Facility | | $958.31 | $1,707.30 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,688.00 / $2,305.81 / $4,791.04
| Facility | | $1,688.00 | $2,305.81 | $4,791.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |