- 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
- $9,195.75 / $12,462.61 / $23,395.49
| Facility | | $9,195.75 | $12,462.61 | $23,395.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,422.98 / $2,279.71 / $7,856.00
| Facility | | $1,422.98 | $2,279.71 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,486.00 / $3,213.23 / $4,524.84
| Facility | | $2,486.00 | $3,213.23 | $4,524.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |