- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $4,897.79 / $23,442.29
| Facility | | $1,122.02 | $4,897.79 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,791.08 / $19,498.45
| Facility | | $6,456.54 | $14,791.08 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,000.00 / $1,148.15
| Facility | | $912.01 | $1,000.00 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,584.89 / $2,290.87
| Facility | | $1,047.13 | $1,584.89 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,481.54 / $17,378.01
| Facility | | $5,011.87 | $11,481.54 | $17,378.01 |