- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,004.44 / $3,977.75 / $10,269.90
| Facility | | $1,004.44 | $3,977.75 | $10,269.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,835.02 / $10,399.86 / $18,360.62
| Facility | | $4,835.02 | $10,399.86 | $18,360.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.69 / $890.00 / $10,845.55
| Facility | | $623.69 | $890.00 | $10,845.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.54 / $4,049.88 / $7,192.19
| Facility | | $422.54 | $4,049.88 | $7,192.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |