- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,623.41 / $13,803.84
| Facility | | $1,778.28 | $5,623.41 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $8,511.38 / $8,912.51
| Facility | | $3,162.28 | $8,511.38 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $12,022.64 / $12,022.64
| Facility | | $977.24 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,412.54 / $11,748.98
| Facility | | $870.96 | $1,412.54 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,248.07 / $8,912.51
| Facility | | $1,995.26 | $5,248.07 | $8,912.51 |