- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,100.08 / $23,483.17
| Facility | | $5,463.36 | $11,100.08 | $23,483.17 |
- 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
- $1,345.55 / $2,404.44 / $15,412.10
| Facility | | $1,345.55 | $2,404.44 | $15,412.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,554.23 / $3,268.95 / $8,854.25
| Facility | | $2,554.23 | $3,268.95 | $8,854.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |