- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,211.62 / $5,707.82 / $10,715.04
| Facility | | $4,211.62 | $5,707.82 | $10,715.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.66 / $1,511.45 / $8,757.16
| Facility | | $945.66 | $1,511.45 | $8,757.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,171.00 / $1,867.66 / $2,838.28
| Facility | | $1,171.00 | $1,867.66 | $2,838.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |