- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,100.08 / $23,483.17
| Facility | | $5,463.36 | $11,100.08 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,218.81 / $10,465.26 / $18,365.84
| Facility | | $7,218.81 | $10,465.26 | $18,365.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.87 / $1,471.77 / $2,157.75
| Facility | | $870.87 | $1,471.77 | $2,157.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,553.00 / $2,157.91 / $2,894.20
| Facility | | $1,553.00 | $2,157.91 | $2,894.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |