- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,611.47 / $24,068.03
| Facility | | $5,463.36 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,093.16 / $10,968.31 / $20,590.32
| Facility | | $8,093.16 | $10,968.31 | $20,590.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.18 / $1,667.82 / $8,632.00
| Facility | | $942.18 | $1,667.82 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,616.00 / $2,121.27 / $2,973.12
| Facility | | $1,616.00 | $2,121.27 | $2,973.12 |
- 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 |