- 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
- $4,873.17 / $6,604.40 / $12,398.15
| Facility | | $4,873.17 | $6,604.40 | $12,398.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,131.96 / $1,980.93 / $7,856.00
| Facility | | $1,131.96 | $1,980.93 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,854.00 / $2,339.77 / $3,646.82
| Facility | | $1,854.00 | $2,339.77 | $3,646.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,126.00 / $4,317.00 / $7,856.00
| Facility | | $3,126.00 | $4,317.00 | $7,856.00 |