- 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
- $1,407.59 / $2,378.83 / $3,492.68
| Facility | | $1,407.59 | $2,378.83 | $3,492.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,552.00 / $3,524.72 / $4,847.81
| Facility | | $2,552.00 | $3,524.72 | $4,847.81 |
- 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 |