- 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
- $5,198.33 / $7,045.08 / $13,225.41
| Facility | | $5,198.33 | $7,045.08 | $13,225.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.06 / $1,447.50 / $9,696.00
| Facility | | $816.06 | $1,447.50 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,536.57 / $1,950.10 / $7,146.52
| Facility | | $1,536.57 | $1,950.10 | $7,146.52 |
- 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 |