- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,611.47 / $25,648.47
| Facility | | $5,463.36 | $11,611.47 | $25,648.47 |
- 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
- $1,472.04 / $2,622.57 / $9,855.12
| Facility | | $1,472.04 | $2,622.57 | $9,855.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,428.00 / $3,407.64 / $5,383.60
| Facility | | $2,428.00 | $3,407.64 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,531.16 / $8,816.00
| Facility | | $6,178.00 | $7,531.16 | $8,816.00 |