- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,998.88 / $6,774.77 / $12,717.97
| Facility | | $4,998.88 | $6,774.77 | $12,717.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.49 / $1,045.70 / $7,772.00
| Facility | | $489.49 | $1,045.70 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $892.26 / $1,153.78 / $3,145.09
| Facility | | $892.26 | $1,153.78 | $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 |