- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.83 / $1,017.83 / $13,509.80
| Facility | | $1,017.83 | $1,017.83 | $13,509.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,548.32 / $13,126.55 / $25,424.06
| Facility | | $4,548.32 | $13,126.55 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,474.14 / $3,510.44 / $8,444.85
| Facility | | $2,474.14 | $3,510.44 | $8,444.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,249.21 / $3,209.39 / $6,649.49
| Facility | | $2,249.21 | $3,209.39 | $6,649.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,049.18 / $1,720.13 / $3,052.16
| Facility | | $1,049.18 | $1,720.13 | $3,052.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |