- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,417.02 / $11,611.47 / $24,068.03
| Facility | | $5,417.02 | $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
- $1,123.66 / $2,643.47 / $8,816.00
| Facility | | $1,123.66 | $2,643.47 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,246.29 / $3,141.50 / $4,188.66
| Facility | | $2,246.29 | $3,141.50 | $4,188.66 |
- 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 |