- 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
- $6,193.47 / $8,978.79 / $15,757.21
| Facility | | $6,193.47 | $8,978.79 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.26 / $1,982.56 / $2,878.67
| Facility | | $1,153.26 | $1,982.56 | $2,878.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $2,852.24 / $3,976.22
| Facility | | $2,097.00 | $2,852.24 | $3,976.22 |
- 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 |