- 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
- $18,424.50 / $24,233.27 / $46,874.97
| Facility | | $18,424.50 | $24,233.27 | $46,874.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,528.27 / $2,317.71 / $13,909.00
| Facility | | $1,528.27 | $2,317.71 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,399.86 / $2,982.35 / $4,032.78
| Facility | | $2,399.86 | $2,982.35 | $4,032.78 |
- 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 |