- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $8,477.27 / $21,899.37
| Facility | | $4,241.22 | $8,477.27 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,195.75 / $12,094.93 / $23,395.49
| Facility | | $9,195.75 | $12,094.93 | $23,395.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.37 / $1,016.33 / $5,020.82
| Facility | | $549.37 | $1,016.33 | $5,020.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.26 / $1,367.53 / $1,901.08
| Facility | | $715.26 | $1,367.53 | $1,901.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |