- 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
- $13,424.93 / $17,657.45 / $34,155.21
| Facility | | $13,424.93 | $17,657.45 | $34,155.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.32 / $1,436.41 / $13,909.00
| Facility | | $918.32 | $1,436.41 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,442.52 / $1,780.20 / $2,422.12
| Facility | | $1,442.52 | $1,780.20 | $2,422.12 |
- 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 |