- 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
- $6,074.79 / $8,806.74 / $15,455.25
| Facility | | $6,074.79 | $8,806.74 | $15,455.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $897.76 / $1,515.00 / $2,222.84
| Facility | | $897.76 | $1,515.00 | $2,222.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,563.09 / $2,205.23 / $3,036.55
| Facility | | $1,563.09 | $2,205.23 | $3,036.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |