- 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
- $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
- $1,070.55 / $1,921.00 / $8,816.00
| Facility | | $1,070.55 | $1,921.00 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,756.00 / $2,501.76 / $5,383.60
| Facility | | $1,756.00 | $2,501.76 | $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 |