- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,611.47 / $24,068.03
| Facility | | $4,241.22 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,949.08 / $7,762.05 / $15,135.42
| Facility | | $5,949.08 | $7,762.05 | $15,135.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,141.50 / $3,141.50 / $3,141.50
| Facility | | $3,141.50 | $3,141.50 | $3,141.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $894.22 / $2,047.07 / $8,816.00
| Facility | | $894.22 | $2,047.07 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,789.63 / $2,485.30 / $4,133.42
| Facility | | $1,789.63 | $2,485.30 | $4,133.42 |
- 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 |