- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $20,928.72
| Facility | | $5,463.36 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,823.60 / $13,313.50 / $24,992.84
| Facility | | $9,823.60 | $13,313.50 | $24,992.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.79 / $1,468.37 / $13,688.88
| Facility | | $683.79 | $1,468.37 | $13,688.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,292.58 / $2,038.66 / $8,958.90
| Facility | | $1,292.58 | $2,038.66 | $8,958.90 |
- 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 |