- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,878.28 / $5,463.36 / $13,841.56
| Facility | | $1,878.28 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,153.73 / $15,116.17 / $28,376.91
| Facility | | $11,153.73 | $15,116.17 | $28,376.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.68 / $3,099.16 / $5,420.97
| Facility | | $481.68 | $3,099.16 | $5,420.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.21 / $3,655.14 / $6,319.22
| Facility | | $843.21 | $3,655.14 | $6,319.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |