- 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
- $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
- $795.54 / $1,425.53 / $7,772.00
| Facility | | $795.54 | $1,425.53 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,496.53 / $1,932.00 / $2,613.12
| Facility | | $1,496.53 | $1,932.00 | $2,613.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |