- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,995.87 / $24,068.03
| Facility | | $5,463.36 | $11,995.87 | $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
- $1,499.24 / $2,671.89 / $8,816.00
| Facility | | $1,499.24 | $2,671.89 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $3,473.51 / $5,383.60
| Facility | | $2,485.00 | $3,473.51 | $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 |