- 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
- $1,786.47 / $2,910.25 / $7,856.00
| Facility | | $1,786.47 | $2,910.25 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,981.00 / $3,994.16 / $5,632.34
| Facility | | $2,981.00 | $3,994.16 | $5,632.34 |
- 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 |