- 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
- $676.21 / $1,284.80 / $8,816.00
| Facility | | $676.21 | $1,284.80 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,277.00 / $1,665.46 / $2,178.32
| Facility | | $1,277.00 | $1,665.46 | $2,178.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |