- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,630.64 / $5,463.36 / $13,841.56
| Facility | | $1,630.64 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,881.23 / $30,095.07 / $58,213.58
| Facility | | $22,881.23 | $30,095.07 | $58,213.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,069.52 / $17,069.52 / $17,069.52
| Facility | | $17,069.52 | $17,069.52 | $17,069.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.12 / $1,211.61 / $9,696.00
| Facility | | $673.12 | $1,211.61 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,356.80 / $1,837.65 / $23,455.40
| Facility | | $1,356.80 | $1,837.65 | $23,455.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $9,496.00 / $11,191.68
| Facility | | $6,777.00 | $9,496.00 | $11,191.68 |