- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $6,606.93 / $13,489.63
| Facility | | $2,238.72 | $6,606.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $10,471.29 / $15,488.17
| Facility | | $3,235.94 | $10,471.29 | $15,488.17 |
- 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 / $9,332.54
| Facility | | $588.84 | $1,445.44 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,244.36 / $10,964.78
| Facility | | $5,495.41 | $7,244.36 | $10,964.78 |