- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.17 / $1,724.55 / $3,335.83
| Facility | | $1,311.17 | $1,724.55 | $3,335.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.44 / $622.08 / $8,816.00
| Facility | | $391.44 | $622.08 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.69 / $752.54 / $1,020.68
| Facility | | $613.69 | $752.54 | $1,020.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,530.30 / $5,387.38 / $8,632.00
| Facility | | $4,530.30 | $5,387.38 | $8,632.00 |