- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,585.78 / $15,488.17
| Facility | | $2,691.53 | $7,585.78 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $12,882.50 / $19,054.61
| Facility | | $7,079.46 | $12,882.50 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $4,365.16
| Facility | | $851.14 | $851.14 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $5,011.87 / $5,248.07
| Facility | | $4,786.30 | $5,011.87 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $8,912.51
| Facility | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,709.64 / $11,748.98
| Facility | | $5,370.32 | $8,709.64 | $11,748.98 |