- 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
- $7,349.44 / $9,666.52 / $18,698.16
| Facility | | $7,349.44 | $9,666.52 | $18,698.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,595.05 / $2,964.77 / $8,220.00
| Facility | | $1,595.05 | $2,964.77 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,261.31 / $4,259.07 / $5,774.83
| Facility | | $2,261.31 | $4,259.07 | $5,774.83 |
- 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 |