- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,119.32 / $8,477.27 / $20,928.72
| Facility | | $2,119.32 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,288.63 / $16,162.90 / $31,264.27
| Facility | | $12,288.63 | $16,162.90 | $31,264.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,273.00 / $2,273.00 / $2,273.00
| Facility | | $2,273.00 | $2,273.00 | $2,273.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.91 / $646.67 / $4,944.24
| Facility | | $326.91 | $646.67 | $4,944.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.25 / $670.00 / $851.72
| Facility | | $506.25 | $670.00 | $851.72 |
- 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 |