- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,578.27 / $7,559.99 / $14,192.03
| Facility | | $5,578.27 | $7,559.99 | $14,192.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.55 / $896.29 / $8,632.00
| Facility | | $506.55 | $896.29 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $955.10 / $1,271.99 / $3,162.53
| Facility | | $955.10 | $1,271.99 | $3,162.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,325.00 / $8,816.00
| Facility | | $4,700.00 | $6,325.00 | $8,816.00 |