- 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
- $6,904.89 / $9,357.90 / $17,567.16
| Facility | | $6,904.89 | $9,357.90 | $17,567.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.27 / $2,327.67 / $9,653.94
| Facility | | $1,322.27 | $2,327.67 | $9,653.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,056.00 / $2,952.68 / $4,003.89
| Facility | | $2,056.00 | $2,952.68 | $4,003.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |