- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,906.94 / $7,769.24 / $15,028.22
| Facility | | $5,906.94 | $7,769.24 | $15,028.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,634.43 / $4,634.43 / $4,634.43
| Facility | | $4,634.43 | $4,634.43 | $4,634.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.16 / $1,146.91 / $9,480.17
| Facility | | $637.16 | $1,146.91 | $9,480.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,088.92 / $1,752.31 / $5,870.28
| Facility | | $1,088.92 | $1,752.31 | $5,870.28 |
- 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 |