- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,751.95 / $13,216.42 / $24,810.59
| Facility | | $9,751.95 | $13,216.42 | $24,810.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $952.22 / $1,690.75 / $8,632.00
| Facility | | $952.22 | $1,690.75 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.00 / $2,271.09 / $4,791.04
| Facility | | $1,650.00 | $2,271.09 | $4,791.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,325.00 / $8,816.00
| Facility | | $4,700.00 | $6,325.00 | $8,816.00 |