- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,681.71 / $7,120.36 / $20,928.72
| Facility | | $1,681.71 | $7,120.36 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,998.88 / $6,774.77 / $12,717.97
| Facility | | $4,998.88 | $6,774.77 | $12,717.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.16 / $565.14 / $5,444.45
| Facility | | $320.16 | $565.14 | $5,444.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.02 / $802.49 / $1,813.25
| Facility | | $603.02 | $802.49 | $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 |