- 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
- $4,896.35 / $6,635.81 / $12,457.11
| Facility | | $4,896.35 | $6,635.81 | $12,457.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.30 / $1,345.53 / $7,856.00
| Facility | | $771.30 | $1,345.53 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,406.49 / $1,741.61 / $2,452.76
| Facility | | $1,406.49 | $1,741.61 | $2,452.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,126.00 / $4,317.00 / $7,856.00
| Facility | | $3,126.00 | $4,317.00 | $7,856.00 |