- 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
- $6,416.80 / $9,302.56 / $16,325.39
| Facility | | $6,416.80 | $9,302.56 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.43 / $1,289.33 / $2,028.92
| Facility | | $758.43 | $1,289.33 | $2,028.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,277.08 / $1,895.73 / $3,033.31
| Facility | | $1,277.08 | $1,895.73 | $3,033.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,751.42 / $6,178.00 / $8,816.00
| Facility | | $2,751.42 | $6,178.00 | $8,816.00 |