- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,641.59 / $10,356.32 / $19,441.45
| Facility | | $7,641.59 | $10,356.32 | $19,441.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.22 / $376.77 / $10,247.57
| Facility | | $208.22 | $376.77 | $10,247.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.21 / $555.22 / $6,461.34
| Facility | | $397.21 | $555.22 | $6,461.34 |
- 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 |