- 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
- $11,018.89 / $14,492.85 / $28,033.86
| Facility | | $11,018.89 | $14,492.85 | $28,033.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.39 / $2,041.06 / $12,519.18
| Facility | | $1,350.39 | $2,041.06 | $12,519.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.89 / $2,656.79 / $3,557.82
| Facility | | $2,137.89 | $2,656.79 | $3,557.82 |
- 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 |