- 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
- $10,242.16 / $13,880.76 / $26,057.73
| Facility | | $10,242.16 | $13,880.76 | $26,057.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.70 / $1,634.38 / $13,688.88
| Facility | | $918.70 | $1,634.38 | $13,688.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.00 / $2,210.48 / $10,138.50
| Facility | | $1,621.00 | $2,210.48 | $10,138.50 |
- 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 |