- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.18 / $11,503.75 / $22,802.43
| Facility | | $1,800.18 | $11,503.75 | $22,802.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,132.63 / $10,843.93 / $18,458.66
| Facility | | $4,132.63 | $10,843.93 | $18,458.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,639.40 / $3,639.40 / $4,676.68
| Facility | | $3,639.40 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.38 / $925.00 / $1,464.90
| Facility | | $644.38 | $925.00 | $1,464.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |