- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $10,232.93 / $12,589.25
| Facility | | $2,041.74 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $7,585.78 / $18,620.87
| Facility | | $2,754.23 | $7,585.78 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,265.80
| Facility | | $4,168.69 | $4,168.69 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,288.25 / $10,471.29
| Facility | | $691.83 | $1,288.25 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,218.10 / $22,908.68
| Facility | | $12,022.64 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $10,232.93 / $27,542.29
| Facility | | $2,089.30 | $10,232.93 | $27,542.29 |