- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,787.71 / $13,841.56
| Facility | | $1,653.00 | $4,787.71 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,366.82 / $7,366.82 / $7,366.82
| Facility | | $7,366.82 | $7,366.82 | $7,366.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.10 / $6,307.81 / $14,417.07
| Facility | | $372.10 | $6,307.81 | $14,417.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.23 / $9,269.59 / $14,027.57
| Facility | | $831.23 | $9,269.59 | $14,027.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |