- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $12,557.99 / $24,068.03
| Facility | | $5,463.36 | $12,557.99 | $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
- $1,273.34 / $2,266.46 / $15,412.10
| Facility | | $1,273.34 | $2,266.46 | $15,412.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,396.92 / $3,209.11 / $8,854.25
| Facility | | $2,396.92 | $3,209.11 | $8,854.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |