- 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
- $679.55 / $1,203.23 / $7,934.00
| Facility | | $679.55 | $1,203.23 | $7,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,279.07 / $1,618.05 / $4,791.04
| Facility | | $1,279.07 | $1,618.05 | $4,791.04 |
- 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 |