- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,925.71 / $10,431.19 / $20,928.72
| Facility | | $2,925.71 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,593.13 / $9,907.12 / $19,318.16
| Facility | | $7,593.13 | $9,907.12 | $19,318.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.84 / $317.81 / $2,538.00
| Facility | | $175.84 | $317.81 | $2,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.06 / $348.37 / $567.30
| Facility | | $178.06 | $348.37 | $567.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |