- 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
- $9,718.25 / $13,170.73 / $24,724.83
| Facility | | $9,718.25 | $13,170.73 | $24,724.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,325.46 / $2,151.54 / $7,856.00
| Facility | | $1,325.46 | $2,151.54 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,240.00 / $2,965.28 / $4,162.99
| Facility | | $2,240.00 | $2,965.28 | $4,162.99 |
- 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 |