- 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
- $858.27 / $1,525.23 / $10,946.80
| Facility | | $858.27 | $1,525.23 | $10,946.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.66 / $2,157.48 / $6,152.06
| Facility | | $1,615.66 | $2,157.48 | $6,152.06 |
- 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 |