- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,034.87 / $9,047.15 / $16,537.34
| Facility | | $5,034.87 | $9,047.15 | $16,537.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,076.01 / $10,462.01 / $18,416.99
| Facility | | $4,076.01 | $10,462.01 | $18,416.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,639.40 / $3,639.40 / $4,676.68
| Facility | | $3,639.40 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $753.17 / $930.38 / $1,656.31
| Facility | | $753.17 | $930.38 | $1,656.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |