- 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
- $8,578.44 / $11,625.99 / $21,824.96
| Facility | | $8,578.44 | $11,625.99 | $21,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.40 / $1,153.76 / $9,696.00
| Facility | | $661.40 | $1,153.76 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,167.13 / $1,517.36 / $5,275.65
| Facility | | $1,167.13 | $1,517.36 | $5,275.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |