- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,611.47 / $24,068.03
| Facility | | $5,463.36 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,584.12 / $13,894.28 / $24,383.56
| Facility | | $9,584.12 | $13,894.28 | $24,383.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.55 / $2,216.52 / $3,270.39
| Facility | | $1,311.55 | $2,216.52 | $3,270.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,359.00 / $3,271.46 / $4,386.97
| Facility | | $2,359.00 | $3,271.46 | $4,386.97 |
- 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 |