- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.50 / $10,506.16 / $21,899.37
| Facility | | $4,570.50 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,889.38 / $7,684.16 / $14,983.55
| Facility | | $5,889.38 | $7,684.16 | $14,983.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,380.43 / $6,380.43 / $6,380.43
| Facility | | $6,380.43 | $6,380.43 | $6,380.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.71 / $2,104.05 / $8,816.00
| Facility | | $675.71 | $2,104.05 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,355.27 / $2,316.59 / $7,656.52
| Facility | | $1,355.27 | $2,316.59 | $7,656.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |