- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $18,620.87
| Facility | | $7,943.28 | $12,589.25 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $8,511.38 / $15,848.93
| Facility | | $3,981.07 | $8,511.38 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $3,388.44
| Facility | | $1,122.02 | $1,122.02 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,380.38 / $2,884.03
| Facility | | $912.01 | $1,380.38 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $17,378.01 / $25,703.96
| Facility | | $2,884.03 | $17,378.01 | $25,703.96 |