- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $8,023.32 / $21,899.37
| Facility | | $5,463.36 | $8,023.32 | $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
- $913.86 / $1,638.26 / $8,816.00
| Facility | | $913.86 | $1,638.26 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,670.34 / $2,136.32 / $5,383.60
| Facility | | $1,670.34 | $2,136.32 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,221.00 / $8,816.00
| Facility | | $6,178.00 | $7,221.00 | $8,816.00 |