- 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
- $1,435.69 / $2,889.57 / $8,816.00
| Facility | | $1,435.69 | $2,889.57 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.05 / $2,856.67 / $3,831.50
| Facility | | $1,660.05 | $2,856.67 | $3,831.50 |
- 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 |