- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,363.43 / $9,544.15 / $20,928.72
| Facility | | $3,363.43 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.40 / $10,415.37 / $18,278.29
| Facility | | $7,184.40 | $10,415.37 | $18,278.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.13 / $746.88 / $1,207.60
| Facility | | $456.13 | $746.88 | $1,207.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,011.65 / $1,276.73 / $4,831.43
| Facility | | $1,011.65 | $1,276.73 | $4,831.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |