- 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
- $1,275.64 / $2,168.59 / $3,246.98
| Facility | | $1,275.64 | $2,168.59 | $3,246.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $3,000.71 / $4,176.95
| Facility | | $2,234.00 | $3,000.71 | $4,176.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |