- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $9,120.11 / $19,054.61
| Facility | | $5,495.41 | $9,120.11 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,943.28 / $14,125.38
| Facility | | $3,235.94 | $7,943.28 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $3,630.78
| Facility | | $2,818.38 | $2,818.38 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,288.25 / $2,238.72
| Facility | | $851.14 | $1,288.25 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |