- 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
- $6,416.80 / $8,696.41 / $16,325.39
| Facility | | $6,416.80 | $8,696.41 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.14 / $1,685.74 / $7,856.00
| Facility | | $1,054.14 | $1,685.74 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.00 / $2,367.52 / $3,319.35
| Facility | | $1,748.00 | $2,367.52 | $3,319.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |