- 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
- $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
- $1,520.97 / $2,371.42 / $17,019.64
| Facility | | $1,520.97 | $2,371.42 | $17,019.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,396.44 / $2,978.10 / $3,413.47
| Facility | | $2,396.44 | $2,978.10 | $3,413.47 |
- 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 |