- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,018.72 / $10,546.81 / $20,400.93
| Facility | | $8,018.72 | $10,546.81 | $20,400.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.50 / $828.63 / $5,405.32
| Facility | | $473.50 | $828.63 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $925.00 / $1,276.01 / $2,961.89
| Facility | | $925.00 | $1,276.01 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |