- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,308.54 / $10,341.11 / $21,899.37
| Facility | | $4,308.54 | $10,341.11 | $21,899.37 |
- 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
- $1,047.28 / $2,157.39 / $8,816.00
| Facility | | $1,047.28 | $2,157.39 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $2,815.14 / $4,133.42
| Facility | | $1,392.00 | $2,815.14 | $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 |