- 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
- $1,224.33 / $1,934.94 / $7,856.00
| Facility | | $1,224.33 | $1,934.94 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,020.00 / $2,753.26 / $3,754.84
| Facility | | $2,020.00 | $2,753.26 | $3,754.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,126.00 / $4,317.00 / $7,856.00
| Facility | | $3,126.00 | $4,317.00 | $7,856.00 |