- 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
- $4,474.97 / $6,064.74 / $11,385.07
| Facility | | $4,474.97 | $6,064.74 | $11,385.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.92 / $689.66 / $7,772.00
| Facility | | $388.92 | $689.66 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.98 / $953.00 / $3,093.19
| Facility | | $729.98 | $953.00 | $3,093.19 |
- 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 |