- 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
- $7,218.81 / $10,465.26 / $18,365.84
| Facility | | $7,218.81 | $10,465.26 | $18,365.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,314.94 / $2,421.01 / $3,430.91
| Facility | | $1,314.94 | $2,421.01 | $3,430.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,424.21 / $3,531.26 / $4,766.38
| Facility | | $2,424.21 | $3,531.26 | $4,766.38 |
- 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 |