- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,169.13 / $6,976.00 / $20,260.64
| Facility | | $1,169.13 | $6,976.00 | $20,260.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,457.08 / $16,192.78 / $36,581.76
| Facility | | $2,457.08 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,103.74 / $4,401.49 / $10,588.39
| Facility | | $3,103.74 | $4,401.49 | $10,588.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,523.12 / $4,024.02 / $8,337.31
| Facility | | $2,523.12 | $4,024.02 | $8,337.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.12 / $2,561.32 / $12,367.00
| Facility | | $1,760.12 | $2,561.32 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |