- 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
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $956.38 / $1,673.67 / $7,441.00
| Facility | | $956.38 | $1,673.67 | $7,441.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,226.65 / $2,330.39 / $3,232.72
| Facility | | $1,226.65 | $2,330.39 | $3,232.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |