- 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
- $1,892.62 / $2,857.53 / $13,909.00
| Facility | | $1,892.62 | $2,857.53 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,977.44 / $3,700.12 / $4,986.93
| Facility | | $2,977.44 | $3,700.12 | $4,986.93 |
- 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 |