- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,757.33 / $10,431.19 / $20,928.72
| Facility | | $1,757.33 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,949.89 / $9,949.89 / $9,949.89
| Facility | | $9,949.89 | $9,949.89 | $9,949.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.32 / $1,776.81 / $9,696.00
| Facility | | $1,015.32 | $1,776.81 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,290.31 / $2,544.67 / $14,444.64
| Facility | | $1,290.31 | $2,544.67 | $14,444.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |