- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,064.08 / $4,152.62 / $7,795.52
| Facility | | $3,064.08 | $4,152.62 | $7,795.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.40 / $1,249.30 / $5,224.18
| Facility | | $236.40 | $1,249.30 | $5,224.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.59 / $1,617.17 / $3,862.74
| Facility | | $479.59 | $1,617.17 | $3,862.74 |
- 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 |