- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,732.29 / $13,189.77 / $24,760.56
| Facility | | $9,732.29 | $13,189.77 | $24,760.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.04 / $1,571.42 / $5,105.63
| Facility | | $312.04 | $1,571.42 | $5,105.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.42 / $2,334.78 / $3,310.62
| Facility | | $637.42 | $2,334.78 | $3,310.62 |
- 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 |