- 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
- $5,489.78 / $7,440.06 / $13,966.90
| Facility | | $5,489.78 | $7,440.06 | $13,966.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.68 / $1,568.75 / $7,856.00
| Facility | | $954.68 | $1,568.75 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $2,131.71 / $2,811.38
| Facility | | $1,481.00 | $2,131.71 | $2,811.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |