- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,501.19 / $11,521.30 / $21,628.42
| Facility | | $8,501.19 | $11,521.30 | $21,628.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.10 / $889.09 / $9,480.17
| Facility | | $540.10 | $889.09 | $9,480.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.85 / $1,212.50 / $5,870.28
| Facility | | $918.85 | $1,212.50 | $5,870.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |