- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,574.38 / $8,477.27 / $20,928.72
| Facility | | $1,574.38 | $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
- $1,574.38 / $2,755.17 / $4,407.77
| Facility | | $1,574.38 | $2,755.17 | $4,407.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,055.81 / $3,990.27 / $5,617.76
| Facility | | $2,055.81 | $3,990.27 | $5,617.76 |
- 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 |