- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,090.30 / $4,897.79
| Facility | | $2,344.23 | $3,090.30 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $19,952.62 / $27,542.29
| Facility | | $9,120.11 | $19,952.62 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,187.76 / $2,454.71
| Facility | | $2,089.30 | $2,187.76 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,715.35 / $3,715.35
| Facility | | $758.58 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,623.41 / $12,022.64
| Facility | | $1,023.29 | $5,623.41 | $12,022.64 |