- 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
- $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
- $1,593.81 / $2,521.14 / $7,856.00
| Facility | | $1,593.81 | $2,521.14 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,588.00 / $3,582.95 / $5,004.55
| Facility | | $2,588.00 | $3,582.95 | $5,004.55 |
- 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 |