- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $6,048.00 / $13,841.56
| Facility | | $2,318.31 | $6,048.00 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- 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
- $600.53 / $1,110.98 / $5,405.32
| Facility | | $600.53 | $1,110.98 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,616.22 / $2,961.89
| Facility | | $953.00 | $1,616.22 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |