- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $21,899.37
| Facility | | $5,463.36 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,646.56 / $11,718.32 / $21,998.27
| Facility | | $8,646.56 | $11,718.32 | $21,998.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.24 / $1,670.85 / $8,632.00
| Facility | | $810.24 | $1,670.85 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,532.41 / $2,041.73 / $4,791.04
| Facility | | $1,532.41 | $2,041.73 | $4,791.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |