- 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
- $13,972.71 / $18,377.93 / $35,548.86
| Facility | | $13,972.71 | $18,377.93 | $35,548.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.40 / $1,950.36 / $13,909.00
| Facility | | $1,240.40 | $1,950.36 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,951.25 / $2,424.86 / $3,263.15
| Facility | | $1,951.25 | $2,424.86 | $3,263.15 |
- 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 |