- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,673.38 / $8,477.27 / $20,928.72
| Facility | | $1,673.38 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,673.38 / $2,928.42 / $4,731.60
| Facility | | $1,673.38 | $2,928.42 | $4,731.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,169.59 / $4,232.41 / $5,961.89
| Facility | | $2,169.59 | $4,232.41 | $5,961.89 |
- 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 |