- 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
- $5,198.33 / $7,045.08 / $13,225.41
| Facility | | $5,198.33 | $7,045.08 | $13,225.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.04 / $459.06 / $7,772.00
| Facility | | $258.04 | $459.06 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.15 / $649.70 / $3,145.09
| Facility | | $487.15 | $649.70 | $3,145.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,688.98 / $5,356.00 / $7,934.00
| Facility | | $2,688.98 | $5,356.00 | $7,934.00 |