- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $23,613.24
| Facility | | $4,241.22 | $10,431.19 | $23,613.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.90 / $12,315.08 / $23,118.55
| Facility | | $9,086.90 | $12,315.08 | $23,118.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,430.82 / $2,578.76 / $8,816.00
| Facility | | $1,430.82 | $2,578.76 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,293.00 / $3,355.93 / $5,383.60
| Facility | | $2,293.00 | $3,355.93 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,531.16 / $8,816.00
| Facility | | $6,178.00 | $7,531.16 | $8,816.00 |