- 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
- $9,823.60 / $13,313.50 / $24,992.84
| Facility | | $9,823.60 | $13,313.50 | $24,992.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,137.94 / $2,030.66 / $15,622.00
| Facility | | $1,137.94 | $2,030.66 | $15,622.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,006.00 / $2,570.66 / $3,568.31
| Facility | | $2,006.00 | $2,570.66 | $3,568.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |