- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,838.93 / $11,364.26 / $19,943.52
| Facility | | $7,838.93 | $11,364.26 | $19,943.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.34 / $915.18 / $1,485.30
| Facility | | $538.34 | $915.18 | $1,485.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.34 / $1,392.00 / $3,033.31
| Facility | | $1,026.34 | $1,392.00 | $3,033.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,178.00 / $8,632.00
| Facility | | $4,700.00 | $6,178.00 | $8,632.00 |