- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,778.28 / $7,762.47
| Facility | | $1,778.28 | $1,778.28 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,454.40 / $41,686.94
| Facility | | $8,511.38 | $14,454.40 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $6,760.83 / $16,218.10
| Facility | | $4,265.80 | $6,760.83 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $6,456.54 / $12,589.25
| Facility | | $5,248.07 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,754.23 / $5,495.41
| Facility | | $1,698.24 | $2,754.23 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,943.28 / $12,589.25
| Facility | | $2,951.21 | $7,943.28 | $12,589.25 |