- 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
- $8,735.75 / $12,664.39 / $22,225.18
| Facility | | $8,735.75 | $12,664.39 | $22,225.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.54 / $1,029.44 / $1,692.33
| Facility | | $605.54 | $1,029.44 | $1,692.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.42 / $1,512.60 / $5,090.60
| Facility | | $1,002.42 | $1,512.60 | $5,090.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |