- 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
- $11,219.04 / $16,264.47 / $28,543.08
| Facility | | $11,219.04 | $16,264.47 | $28,543.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,706.13 / $2,900.42 / $4,207.88
| Facility | | $1,706.13 | $2,900.42 | $4,207.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.00 / $4,240.87 / $5,780.41
| Facility | | $3,066.00 | $4,240.87 | $5,780.41 |
- 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 |