- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.16 / $7,190.50 / $14,740.66
| Facility | | $1,205.16 | $7,190.50 | $14,740.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,015.76 / $6,599.76 / $27,560.64
| Facility | | $5,015.76 | $6,599.76 | $27,560.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $10,972.24 / $28,970.26
| Facility | | $8,639.91 | $10,972.24 | $28,970.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,794.86 / $9,870.24 / $21,332.62
| Facility | | $2,794.86 | $9,870.24 | $21,332.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,214.52 / $6,548.04 / $17,534.55
| Facility | | $4,214.52 | $6,548.04 | $17,534.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.35 / $6,774.00 / $14,462.24
| Facility | | $1,101.35 | $6,774.00 | $14,462.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.38 / $729.38 / $903.86
| Facility | | $729.38 | $729.38 | $903.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |