- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,915.56 / $24,068.03
| Facility | | $5,463.36 | $10,915.56 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,478.60 / $8,780.17 / $16,482.62
| Facility | | $6,478.60 | $8,780.17 | $16,482.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.37 / $290.85 / $4,989.20
| Facility | | $175.37 | $290.85 | $4,989.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.85 / $417.23 / $1,583.32
| Facility | | $264.85 | $417.23 | $1,583.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |