- 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
- $14,877.26 / $20,162.50 / $37,850.17
| Facility | | $14,877.26 | $20,162.50 | $37,850.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.40 / $1,250.17 / $7,856.00
| Facility | | $784.40 | $1,250.17 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,323.00 / $1,762.00 / $2,472.56
| Facility | | $1,323.00 | $1,762.00 | $2,472.56 |
- 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 |