- 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
- $2,364.25 / $3,606.20 / $13,909.00
| Facility | | $2,364.25 | $3,606.20 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,716.26 / $4,620.78 / $6,252.74
| Facility | | $3,716.26 | $4,620.78 | $6,252.74 |
- 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 |