- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,003.92 / $12,015.13 / $27,394.37
| Facility | | $1,003.92 | $12,015.13 | $27,394.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $14,812.00 / $33,821.32
| Facility | | $4,008.00 | $14,812.00 | $33,821.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.46 / $1,224.33 / $1,451.07
| Facility | | $979.46 | $1,224.33 | $1,451.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,330.00 / $17,416.00
| Facility | | $5,431.00 | $12,330.00 | $17,416.00 |