- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,630.27 / $5,495.41
| Facility | | $1,318.26 | $2,630.27 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,918.31 / $18,620.87
| Facility | | $2,454.71 | $6,918.31 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $6,165.95
| Facility | | $6,165.95 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,096.48 / $2,511.89
| Facility | | $457.09 | $1,096.48 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,488.17 / $22,908.68
| Facility | | $12,302.69 | $15,488.17 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $11,748.98 / $29,512.09
| Facility | | $2,570.40 | $11,748.98 | $29,512.09 |