- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $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
- $634.60 / $1,123.72 / $9,496.00
| Facility | | $634.60 | $1,123.72 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.00 / $1,511.20 / $4,791.04
| Facility | | $1,110.00 | $1,511.20 | $4,791.04 |
- 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 |