- 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
- $9,426.81 / $12,775.74 / $23,983.33
| Facility | | $9,426.81 | $12,775.74 | $23,983.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,104.09 / $4,820.22 / $7,856.00
| Facility | | $3,104.09 | $4,820.22 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,909.33 / $7,044.35 / $9,522.40
| Facility | | $4,909.33 | $7,044.35 | $9,522.40 |
- 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 |