- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $12,036.14 / $24,068.03
| Facility | | $5,463.36 | $12,036.14 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,547.24 / $20,448.87 / $39,554.72
| Facility | | $15,547.24 | $20,448.87 | $39,554.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.66 / $1,058.51 / $17,519.00
| Facility | | $696.66 | $1,058.51 | $17,519.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.07 / $1,323.64 / $1,581.39
| Facility | | $1,095.07 | $1,323.64 | $1,581.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |