- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,276.95 / $9,047.14 / $22,716.74
| Facility | | $5,276.95 | $9,047.14 | $22,716.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,866.35 / $8,410.20 / $17,709.07
| Facility | | $2,866.35 | $8,410.20 | $17,709.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.44 / $2,000.00 / $5,740.31
| Facility | | $1,200.44 | $2,000.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,169.18 / $1,459.70 / $2,330.41
| Facility | | $1,169.18 | $1,459.70 | $2,330.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |