- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $9,120.11 / $16,595.87
| Facility | | $1,318.26 | $9,120.11 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $8,511.38 / $14,454.40
| Facility | | $2,398.83 | $8,511.38 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $11,481.54
| Facility | | $8,912.51 | $8,912.51 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $4,265.80 / $10,715.19
| Facility | | $467.74 | $4,265.80 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $25,703.96
| Facility | | $8,709.64 | $20,417.38 | $25,703.96 |