- 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
- $5,779.83 / $7,833.15 / $14,704.82
| Facility | | $5,779.83 | $7,833.15 | $14,704.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.25 / $548.41 / $7,934.00
| Facility | | $275.25 | $548.41 | $7,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.86 / $759.03 / $4,164.35
| Facility | | $517.86 | $759.03 | $4,164.35 |
- 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 |