- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,849.40 / $8,477.27 / $21,899.37
| Facility | | $1,849.40 | $8,477.27 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.90 / $11,951.75 / $23,118.55
| Facility | | $9,086.90 | $11,951.75 | $23,118.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,556.27 / $5,556.27 / $5,556.27
| Facility | | $5,556.27 | $5,556.27 | $5,556.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.08 / $2,068.36 / $7,221.00
| Facility | | $1,120.08 | $2,068.36 | $7,221.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,484.52 / $4,213.93 / $6,667.52
| Facility | | $2,484.52 | $4,213.93 | $6,667.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |