- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $11,481.54 / $15,848.93
| Facility | | $1,023.29 | $11,481.54 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,288.25
| Facility | | $1,047.13 | $1,047.13 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,698.24 / $1,698.24
| Facility | | $34.67 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $26,915.35
| Facility | | $13,803.84 | $13,803.84 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $14,125.38
| Facility | | $2,884.03 | $2,884.03 | $14,125.38 |