- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,492.64 / $5,515.65 / $16,122.49
| Facility | | $1,492.64 | $5,515.65 | $16,122.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,907.30 / $9,425.79 / $17,744.71
| Facility | | $3,907.30 | $9,425.79 | $17,744.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.45 / $715.00 / $7,403.43
| Facility | | $639.45 | $715.00 | $7,403.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.46 / $660.00 / $1,194.18
| Facility | | $557.46 | $660.00 | $1,194.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |