- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,611.47 / $24,068.03
| Facility | | $5,463.36 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,970.26 / $10,801.75 / $20,277.64
| Facility | | $7,970.26 | $10,801.75 | $20,277.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.00 / $1,259.95 / $8,816.00
| Facility | | $704.00 | $1,259.95 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,323.55 / $1,759.56 / $5,383.60
| Facility | | $1,323.55 | $1,759.56 | $5,383.60 |
- 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 |