- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.68 / $9,476.87 / $17,790.50
| Facility | | $6,992.68 | $9,476.87 | $17,790.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.49 / $1,441.11 / $7,382.76
| Facility | | $823.49 | $1,441.11 | $7,382.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,496.00 / $1,986.89 / $2,798.96
| Facility | | $1,496.00 | $1,986.89 | $2,798.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |