- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $14,791.08 / $31,622.78
| Facility | | $7,943.28 | $14,791.08 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $10,232.93 / $19,054.61
| Facility | | $4,265.80 | $10,232.93 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $7,943.28
| Facility | | $6,165.95 | $6,165.95 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,819.70 / $2,951.21
| Facility | | $1,288.25 | $1,819.70 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $25,703.96
| Facility | | $8,709.64 | $20,417.38 | $25,703.96 |