- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,416.80 / $8,696.41 / $16,325.39
| Facility | | $6,416.80 | $8,696.41 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.96 / $1,124.38 / $8,163.00
| Facility | | $699.96 | $1,124.38 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.00 / $1,561.12 / $2,180.58
| Facility | | $1,148.00 | $1,561.12 | $2,180.58 |
- 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 |