- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $7,413.10 / $18,620.87
| Facility | | $1,949.84 | $7,413.10 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $9,120.11 / $17,378.01
| Facility | | $7,079.46 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,737.80 / $13,182.57
| Facility | | $1,148.15 | $1,737.80 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,918.31 / $13,182.57
| Facility | | $2,818.38 | $6,918.31 | $13,182.57 |