- 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
- $9,086.90 / $11,856.11 / $23,118.55
| Facility | | $9,086.90 | $11,856.11 | $23,118.55 |
- 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
- $1,639.24 / $3,416.81 / $8,816.00
| Facility | | $1,639.24 | $3,416.81 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,912.46 / $3,174.08 / $4,673.06
| Facility | | $1,912.46 | $3,174.08 | $4,673.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,694.25 / $5,582.35 / $8,632.00
| Facility | | $4,694.25 | $5,582.35 | $8,632.00 |