- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,389.44 / $6,324.65 / $13,841.56
| Facility | | $2,389.44 | $6,324.65 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,283.48 / $11,226.25 / $21,074.53
| Facility | | $8,283.48 | $11,226.25 | $21,074.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.32 / $1,291.70 / $12,068.20
| Facility | | $730.32 | $1,291.70 | $12,068.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,259.00 / $1,646.96 / $2,291.12
| Facility | | $1,259.00 | $1,646.96 | $2,291.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |