- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,928.06 / $24,068.03
| Facility | | $5,463.36 | $11,928.06 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,638.95 / $13,993.13 / $27,067.23
| Facility | | $10,638.95 | $13,993.13 | $27,067.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.48 / $6,990.06 / $12,304.10
| Facility | | $437.48 | $6,990.06 | $12,304.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.75 / $9,635.06 / $15,898.72
| Facility | | $794.75 | $9,635.06 | $15,898.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |