- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,338.54 / $11,076.80 / $14,858.60
| Facility | | $5,338.54 | $11,076.80 | $14,858.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,058.38 / $15,063.33 / $19,816.62
| Facility | | $6,058.38 | $15,063.33 | $19,816.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $9,778.14 / $11,626.67
| Facility | | $2,651.00 | $9,778.14 | $11,626.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,415.28 / $11,438.00 / $18,003.06
| Facility | | $9,415.28 | $11,438.00 | $18,003.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $14,131.35
| Facility | | $1,350.00 | $5,713.00 | $14,131.35 |