- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.59 / $10,431.19 / $21,899.37
| Facility | | $5,266.59 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,813.88 / $17,126.81 / $30,056.44
| Facility | | $11,813.88 | $17,126.81 | $30,056.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.85 / $1,086.05 / $2,040.00
| Facility | | $638.85 | $1,086.05 | $2,040.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,235.83 / $1,599.00 / $5,251.23
| Facility | | $1,235.83 | $1,599.00 | $5,251.23 |
- 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 |