- 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
- $15,856.25 / $22,987.11 / $40,340.87
| Facility | | $15,856.25 | $22,987.11 | $40,340.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.32 / $1,837.57 / $2,667.40
| Facility | | $1,087.32 | $1,837.57 | $2,667.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,922.00 / $2,697.21 / $3,594.48
| Facility | | $1,922.00 | $2,697.21 | $3,594.48 |
- 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 |