- 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
- $4,474.97 / $6,064.74 / $11,385.07
| Facility | | $4,474.97 | $6,064.74 | $11,385.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.47 / $332.20 / $7,772.00
| Facility | | $179.47 | $332.20 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.90 / $448.69 / $3,093.19
| Facility | | $335.90 | $448.69 | $3,093.19 |
- 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 |