- 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
- $2,199.59 / $3,678.00 / $5,186.81
| Facility | | $2,199.59 | $3,678.00 | $5,186.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,843.00 / $5,192.82 / $7,194.37
| Facility | | $3,843.00 | $5,192.82 | $7,194.37 |
- 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 |