- 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
- $677.94 / $1,616.43 / $4,406.00
| Facility | | $677.94 | $1,616.43 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.00 / $1,675.40 / $2,279.17
| Facility | | $1,298.00 | $1,675.40 | $2,279.17 |
- 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 |