- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $20,928.72
| Facility | | $5,463.36 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,593.13 / $9,907.12 / $19,318.16
| Facility | | $7,593.13 | $9,907.12 | $19,318.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,380.56 / $2,380.56 / $2,380.56
| Facility | | $2,380.56 | $2,380.56 | $2,380.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.47 / $1,430.13 / $9,001.70
| Facility | | $620.47 | $1,430.13 | $9,001.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,162.69 / $1,729.13 / $3,015.38
| Facility | | $1,162.69 | $1,729.13 | $3,015.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |