- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,611.47 / $24,068.03
| Facility | | $5,463.36 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,578.44 / $11,625.99 / $21,824.96
| Facility | | $8,578.44 | $11,625.99 | $21,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,625.68 / $2,649.03 / $7,772.00
| Facility | | $1,625.68 | $2,649.03 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,820.00 / $3,760.82 / $5,158.89
| Facility | | $2,820.00 | $3,760.82 | $5,158.89 |
- 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 |