- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,193.47 / $8,393.75 / $15,757.21
| Facility | | $6,193.47 | $8,393.75 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.56 / $1,888.79 / $8,816.00
| Facility | | $1,059.56 | $1,888.79 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,726.00 / $2,455.63 / $5,383.60
| Facility | | $1,726.00 | $2,455.63 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,612.14 / $7,221.00 / $8,816.00
| Facility | | $4,612.14 | $7,221.00 | $8,816.00 |