- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,904.89 / $9,357.90 / $17,567.16
| Facility | | $6,904.89 | $9,357.90 | $17,567.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $798.48 / $1,417.21 / $9,653.94
| Facility | | $798.48 | $1,417.21 | $9,653.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,327.02 / $1,949.89 / $4,968.71
| Facility | | $1,327.02 | $1,949.89 | $4,968.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $7,934.00 / $9,653.94
| Facility | | $4,217.00 | $7,934.00 | $9,653.94 |