- 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
- $5,578.27 / $7,559.99 / $14,192.03
| Facility | | $5,578.27 | $7,559.99 | $14,192.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.54 / $1,091.66 / $8,632.00
| Facility | | $615.54 | $1,091.66 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,162.69 / $1,470.30 / $3,145.09
| Facility | | $1,162.69 | $1,470.30 | $3,145.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |