- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,042.03 / $19,276.96
| Facility | | $4,083.97 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,024.04 / $19,760.71 / $38,223.60
| Facility | | $15,024.04 | $19,760.71 | $38,223.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,211.09 / $8,211.09 / $8,211.09
| Facility | | $8,211.09 | $8,211.09 | $8,211.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.16 / $1,126.11 / $9,715.29
| Facility | | $602.16 | $1,126.11 | $9,715.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,619.48 / $10,445.10
| Facility | | $1,089.00 | $1,619.48 | $10,445.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |