- 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
- $6,725.11 / $8,845.35 / $17,109.75
| Facility | | $6,725.11 | $8,845.35 | $17,109.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.64 / $409.26 / $8,816.00
| Facility | | $274.64 | $409.26 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.18 / $649.73 / $3,018.60
| Facility | | $431.18 | $649.73 | $3,018.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |