- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,368.03 / $5,431.20 / $14,026.20
| Facility | | $1,368.03 | $5,431.20 | $14,026.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,178.23 / $17,908.96 / $36,581.76
| Facility | | $7,178.23 | $17,908.96 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,180.59 / $4,964.07 / $11,941.75
| Facility | | $3,180.59 | $4,964.07 | $11,941.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,756.26 / $4,530.04 / $9,402.95
| Facility | | $2,756.26 | $4,530.04 | $9,402.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,505.09 / $2,905.14 / $11,363.36
| Facility | | $1,505.09 | $2,905.14 | $11,363.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $9,370.00 / $12,774.00
| Facility | | $3,437.00 | $9,370.00 | $12,774.00 |