- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.65 / $9,144.62 / $17,688.66
| Facility | | $6,952.65 | $9,144.62 | $17,688.66 |
- 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
- $623.54 / $1,091.20 / $5,405.32
| Facility | | $623.54 | $1,091.20 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.54 / $1,558.09 / $2,961.89
| Facility | | $723.54 | $1,558.09 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $5,356.00 / $7,934.00
| Facility | | $2,529.66 | $5,356.00 | $7,934.00 |