- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,136.43 / $4,778.89 / $13,841.56
| Facility | | $1,136.43 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,937.37 / $12,937.37 / $12,937.37
| Facility | | $12,937.37 | $12,937.37 | $12,937.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.52 / $1,806.91 / $8,816.00
| Facility | | $1,032.52 | $1,806.91 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.61 / $2,646.46 / $16,446.53
| Facility | | $1,361.61 | $2,646.46 | $16,446.53 |
- 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 |