- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,100.08 / $23,483.17
| Facility | | $5,463.36 | $11,100.08 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,118.27 / $6,731.93 / $13,021.72
| Facility | | $5,118.27 | $6,731.93 | $13,021.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.19 / $1,416.14 / $9,696.00
| Facility | | $949.19 | $1,416.14 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,504.67 / $1,869.88 / $2,509.32
| Facility | | $1,504.67 | $1,869.88 | $2,509.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,729.16 / $8,002.25 / $9,496.00
| Facility | | $6,729.16 | $8,002.25 | $9,496.00 |