- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,456.54 / $13,489.63
| Facility | | $2,137.96 | $6,456.54 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,398.83 / $3,311.31
| Facility | | $691.83 | $2,398.83 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,022.64 / $18,620.87
| Facility | | $8,317.64 | $12,022.64 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,445.44 / $22,908.68
| Facility | | $588.84 | $1,445.44 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $16,982.44 / $23,988.33
| Facility | | $6,918.31 | $16,982.44 | $23,988.33 |