- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $20,928.72
| Facility | | $5,463.36 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,165.50 / $10,739.86 / $20,774.36
| Facility | | $8,165.50 | $10,739.86 | $20,774.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.84 / $482.12 / $9,696.00
| Facility | | $250.84 | $482.12 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.40 / $558.12 / $5,718.15
| Facility | | $391.40 | $558.12 | $5,718.15 |
- 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 |