- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,274.15 / $1,274.15 / $11,352.03
| Facility | | $1,274.15 | $1,274.15 | $11,352.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,578.25 / $10,876.99 / $21,650.55
| Facility | | $5,578.25 | $10,876.99 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,109.64 / $4,409.85 / $10,608.50
| Facility | | $3,109.64 | $4,409.85 | $10,608.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,527.91 / $4,031.66 / $8,353.15
| Facility | | $2,527.91 | $4,031.66 | $8,353.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.60 / $2,580.04 / $10,878.00
| Facility | | $1,700.60 | $2,580.04 | $10,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |