- 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
- $9,506.16 / $12,883.29 / $24,185.23
| Facility | | $9,506.16 | $12,883.29 | $24,185.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,124.14 / $1,793.80 / $7,856.00
| Facility | | $1,124.14 | $1,793.80 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,739.00 / $2,524.73 / $3,485.45
| Facility | | $1,739.00 | $2,524.73 | $3,485.45 |
- 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 |