- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,281.85 / $5,631.80 / $10,893.72
| Facility | | $4,281.85 | $5,631.80 | $10,893.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.10 / $1,211.30 / $7,856.00
| Facility | | $507.10 | $1,211.30 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.00 / $1,230.71 / $1,702.76
| Facility | | $964.00 | $1,230.71 | $1,702.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,126.00 / $4,317.00 / $7,856.00
| Facility | | $3,126.00 | $4,317.00 | $7,856.00 |