- 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
- $733.63 / $1,302.89 / $8,159.60
| Facility | | $733.63 | $1,302.89 | $8,159.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,299.00 / $1,680.57 / $2,294.25
| Facility | | $1,299.00 | $1,680.57 | $2,294.25 |
- 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 |