- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.83 / $6,491.65 / $13,056.41
| Facility | | $932.83 | $6,491.65 | $13,056.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,467.56 / $10,188.53 / $21,041.85
| Facility | | $4,467.56 | $10,188.53 | $21,041.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,279.17 / $3,232.14 / $7,775.35
| Facility | | $2,279.17 | $3,232.14 | $7,775.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,852.80 / $2,954.95 / $6,122.33
| Facility | | $1,852.80 | $2,954.95 | $6,122.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,319.93 / $2,401.23 / $11,680.00
| Facility | | $1,319.93 | $2,401.23 | $11,680.00 |
- 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 |