- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,289.74 / $9,588.01 / $18,546.30
| Facility | | $7,289.74 | $9,588.01 | $18,546.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.88 / $1,891.71 / $6,935.62
| Facility | | $114.88 | $1,891.71 | $6,935.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.98 / $3,653.41 / $4,887.64
| Facility | | $229.98 | $3,653.41 | $4,887.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |