- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,932.56 / $8,056.00 / $20,928.72
| Facility | | $1,932.56 | $8,056.00 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,451.74 / $4,678.00 / $8,781.79
| Facility | | $3,451.74 | $4,678.00 | $8,781.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.43 / $551.53 / $4,217.00
| Facility | | $324.43 | $551.53 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.66 / $808.60 / $2,929.96
| Facility | | $650.66 | $808.60 | $2,929.96 |
- 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 |