- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $8,477.27 / $21,899.37
| Facility | | $5,463.36 | $8,477.27 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.68 / $9,476.87 / $17,790.50
| Facility | | $6,992.68 | $9,476.87 | $17,790.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.74 / $1,177.49 / $9,696.00
| Facility | | $671.74 | $1,177.49 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.14 / $1,559.83 / $5,275.65
| Facility | | $1,249.14 | $1,559.83 | $5,275.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |