- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,209.47 / $11,904.55 / $37,798.82
| Facility | | $1,209.47 | $11,904.55 | $37,798.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,348.81 / $16,863.00 / $28,514.91
| Facility | | $6,348.81 | $16,863.00 | $28,514.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,639.40 / $3,639.40 / $4,676.68
| Facility | | $3,639.40 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.20 / $1,197.00 / $2,071.15
| Facility | | $831.20 | $1,197.00 | $2,071.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,294.18 / $17,146.00 / $24,161.00
| Facility | | $4,294.18 | $17,146.00 | $24,161.00 |