- 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
- $7,585.41 / $9,976.87 / $19,298.50
| Facility | | $7,585.41 | $9,976.87 | $19,298.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,338.66 / $2,002.11 / $12,378.96
| Facility | | $1,338.66 | $2,002.11 | $12,378.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,111.42 / $2,608.42 / $3,540.47
| Facility | | $2,111.42 | $2,608.42 | $3,540.47 |
- 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 |