- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,105.01 / $7,838.38 / $8,644.27
| Facility | | $1,105.01 | $7,838.38 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,835.87 / $16,845.77 / $27,473.25
| Facility | | $6,835.87 | $16,845.77 | $27,473.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.45 / $1,205.45 / $1,205.45
| Facility | | $1,205.45 | $1,205.45 | $1,205.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.56 / $1,233.30 / $1,587.10
| Facility | | $966.56 | $1,233.30 | $1,587.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,002.00 / $15,131.00 / $16,269.00
| Facility | | $2,002.00 | $15,131.00 | $16,269.00 |