- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,754.23 / $11,481.54
| Facility | | $1,202.26 | $2,754.23 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $11,220.18 / $23,988.33
| Facility | | $8,912.51 | $11,220.18 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $1,258.93
| Facility | | $776.25 | $776.25 | $1,258.93 |