- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,552.01 / $1,552.01 / $14,015.35
| Facility | | $1,552.01 | $1,552.01 | $14,015.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,919.27 / $11,098.97 / $21,650.55
| Facility | | $5,919.27 | $11,098.97 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,593.10 / $5,095.46 / $12,257.82
| Facility | | $3,593.10 | $5,095.46 | $12,257.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,920.93 / $4,658.47 / $9,651.83
| Facility | | $2,920.93 | $4,658.47 | $9,651.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,813.98 / $2,929.81 / $11,723.67
| Facility | | $1,813.98 | $2,929.81 | $11,723.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,331.00 / $11,165.00 / $19,570.91
| Facility | | $5,331.00 | $11,165.00 | $19,570.91 |