- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $931.15 / $1,629.51 / $8,220.00
| Facility | | $931.15 | $1,629.51 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.20 / $2,307.35 / $3,164.74
| Facility | | $1,181.20 | $2,307.35 | $3,164.74 |
- 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 |