- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.51 / $9,858.65 / $19,069.81
| Facility | | $7,495.51 | $9,858.65 | $19,069.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.13 / $7,244.13 / $7,244.13
| Facility | | $7,244.13 | $7,244.13 | $7,244.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.08 / $1,167.72 / $8,816.00
| Facility | | $662.08 | $1,167.72 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,333.62 / $1,681.00 / $9,175.90
| Facility | | $1,333.62 | $1,681.00 | $9,175.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,221.00 / $8,816.00
| Facility | | $6,178.00 | $7,221.00 | $8,816.00 |