- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,416.80 / $9,302.56 / $16,325.39
| Facility | | $6,416.80 | $9,302.56 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.61 / $1,593.94 / $2,731.70
| Facility | | $937.61 | $1,593.94 | $2,731.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,693.00 / $2,331.14 / $3,285.96
| Facility | | $1,693.00 | $2,331.14 | $3,285.96 |
- 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 |