- 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
- $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
- $522.53 / $914.43 / $5,405.32
| Facility | | $522.53 | $914.43 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,403.59 / $2,961.89
| Facility | | $953.00 | $1,403.59 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.98 / $5,341.00 / $8,632.00
| Facility | | $4,038.98 | $5,341.00 | $8,632.00 |