- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $24,068.03
| Facility | | $5,463.36 | $10,506.16 | $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
- $974.06 / $1,733.94 / $8,632.00
| Facility | | $974.06 | $1,733.94 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,701.00 / $2,250.71 / $3,085.76
| Facility | | $1,701.00 | $2,250.71 | $3,085.76 |
- 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 |