- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,100.08 / $23,483.17
| Facility | | $5,463.36 | $11,100.08 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,018.89 / $14,492.85 / $28,033.86
| Facility | | $11,018.89 | $14,492.85 | $28,033.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,022.66 / $1,561.66 / $9,696.00
| Facility | | $1,022.66 | $1,561.66 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,602.95 / $1,992.01 / $2,705.51
| Facility | | $1,602.95 | $1,992.01 | $2,705.51 |
- 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 |