- 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
- $1,387.89 / $2,073.78 / $8,816.00
| Facility | | $1,387.89 | $2,073.78 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,265.00 / $2,906.11 / $3,876.75
| Facility | | $2,265.00 | $2,906.11 | $3,876.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,178.00 / $8,632.00
| Facility | | $4,700.00 | $6,178.00 | $8,632.00 |