- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,889.60 / $20,928.72
| Facility | | $5,463.36 | $10,889.60 | $20,928.72 |
- 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
- $569.94 / $968.90 / $1,604.70
| Facility | | $569.94 | $968.90 | $1,604.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.00 / $1,413.38 / $2,000.16
| Facility | | $1,026.00 | $1,413.38 | $2,000.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |