- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.50 / $10,506.16 / $21,899.37
| Facility | | $4,570.50 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,833.84 / $6,306.95 / $12,298.09
| Facility | | $4,833.84 | $6,306.95 | $12,298.09 |
- 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
- $1,354.68 / $2,589.84 / $8,816.00
| Facility | | $1,354.68 | $2,589.84 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,077.67 / $2,900.22 / $3,824.77
| Facility | | $2,077.67 | $2,900.22 | $3,824.77 |
- 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 |