- 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
- $5,779.83 / $7,833.15 / $14,704.82
| Facility | | $5,779.83 | $7,833.15 | $14,704.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.06 / $750.58 / $7,441.00
| Facility | | $456.06 | $750.58 | $7,441.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $752.00 / $1,013.09 / $1,416.25
| Facility | | $752.00 | $1,013.09 | $1,416.25 |
- 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 |