- 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
- $20,988.56 / $27,605.70 / $53,398.33
| Facility | | $20,988.56 | $27,605.70 | $53,398.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,530.48 / $2,280.71 / $8,816.00
| Facility | | $1,530.48 | $2,280.71 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,357.00 / $2,997.30 / $4,009.45
| Facility | | $2,357.00 | $2,997.30 | $4,009.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,342.50 / $7,221.00 / $8,816.00
| Facility | | $4,342.50 | $7,221.00 | $8,816.00 |