- 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
- $619.57 / $1,467.54 / $6,396.88
| Facility | | $619.57 | $1,467.54 | $6,396.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,206.00 / $1,521.09 / $2,080.44
| Facility | | $1,206.00 | $1,521.09 | $2,080.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |