- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $10,964.78 / $14,791.08
| Facility | | $4,365.16 | $10,964.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $12,302.69 / $26,302.68
| Facility | | $11,220.18 | $12,302.69 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,232.93 / $11,748.98
| Facility | | $7,585.78 | $10,232.93 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $11,748.98 / $16,218.10
| Facility | | $9,332.54 | $11,748.98 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,309.57 / $14,454.40
| Facility | | $1,819.70 | $6,309.57 | $14,454.40 |