- 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
- $14,535.24 / $21,072.03 / $36,980.03
| Facility | | $14,535.24 | $21,072.03 | $36,980.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.36 / $1,178.54 / $1,714.43
| Facility | | $697.36 | $1,178.54 | $1,714.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,225.00 / $1,736.53 / $2,304.71
| Facility | | $1,225.00 | $1,736.53 | $2,304.71 |
- 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 |