- 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
- $8,383.91 / $11,027.13 / $21,330.03
| Facility | | $8,383.91 | $11,027.13 | $21,330.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,235.81 / $1,889.14 / $13,875.07
| Facility | | $1,235.81 | $1,889.14 | $13,875.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,936.71 / $2,406.78 / $3,253.65
| Facility | | $1,936.71 | $2,406.78 | $3,253.65 |
- 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 |