- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $12,029.70 / $24,068.03
| Facility | | $5,463.36 | $12,029.70 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,543.08 / $22,420.13 / $42,088.31
| Facility | | $16,543.08 | $22,420.13 | $42,088.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.08 / $1,006.39 / $21,435.32
| Facility | | $575.08 | $1,006.39 | $21,435.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.83 / $1,875.02 / $19,577.61
| Facility | | $1,151.83 | $1,875.02 | $19,577.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |