- 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
- $7,970.26 / $11,554.64 / $20,277.64
| Facility | | $7,970.26 | $11,554.64 | $20,277.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,998.52 / $3,397.48 / $4,693.13
| Facility | | $1,998.52 | $3,397.48 | $4,693.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,497.00 / $4,700.12 / $6,561.58
| Facility | | $3,497.00 | $4,700.12 | $6,561.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,483.00 / $7,934.00
| Facility | | $3,711.00 | $5,483.00 | $7,934.00 |