- 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
- $1,445.71 / $2,443.25 / $3,577.42
| Facility | | $1,445.71 | $2,443.25 | $3,577.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,604.00 / $3,588.03 / $4,906.81
| Facility | | $2,604.00 | $3,588.03 | $4,906.81 |
- 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 |