- 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
- $2,757.23 / $4,406.00 / $6,512.33
| Facility | | $2,757.23 | $4,406.00 | $6,512.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,671.00 / $6,462.11 / $9,099.01
| Facility | | $4,671.00 | $6,462.11 | $9,099.01 |
- 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 |