- 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
- $9,990.74 / $13,540.02 / $25,418.08
| Facility | | $9,990.74 | $13,540.02 | $25,418.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.86 / $1,686.36 / $7,772.00
| Facility | | $945.86 | $1,686.36 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,633.00 / $2,113.52 / $2,996.08
| Facility | | $1,633.00 | $2,113.52 | $2,996.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |