- 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
- $31,744.80 / $41,753.08 / $80,763.95
| Facility | | $31,744.80 | $41,753.08 | $80,763.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,056.43 / $1,612.91 / $11,863.72
| Facility | | $1,056.43 | $1,612.91 | $11,863.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.72 / $2,046.56 / $2,788.23
| Facility | | $1,659.72 | $2,046.56 | $2,788.23 |
- 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 |