- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $6,456.54 / $18,620.87
| Facility | | $2,754.23 | $6,456.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $22,908.68 / $23,988.33
| Facility | | $21,877.62 | $22,908.68 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $16,982.44 / $16,982.44
| Facility | | $630.96 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,041.74 / $10,232.93
| Facility | | $1,318.26 | $2,041.74 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $6,918.31 / $19,498.45
| Facility | | $2,884.03 | $6,918.31 | $19,498.45 |