- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $18,197.01 / $28,840.32
| Facility | | $12,882.50 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,187.76 / $3,467.37
| Facility | | $1,862.09 | $2,187.76 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $7,762.47 / $14,454.40
| Facility | | $851.14 | $7,762.47 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,388.44 / $9,549.93
| Facility | | $851.14 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $4,786.30
| Facility | | $1,862.09 | $1,862.09 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $17,782.79 / $19,498.45
| Facility | | $16,982.44 | $17,782.79 | $19,498.45 |