- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $21,899.37
| Facility | | $5,463.36 | $10,431.19 | $21,899.37 |
- 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
- $267.67 / $475.68 / $7,772.00
| Facility | | $267.67 | $475.68 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.59 / $675.15 / $3,093.19
| Facility | | $505.59 | $675.15 | $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 |