- 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
- $605.40 / $1,073.59 / $13,688.88
| Facility | | $605.40 | $1,073.59 | $13,688.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.00 / $1,440.20 / $8,863.74
| Facility | | $1,110.00 | $1,440.20 | $8,863.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |