- 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
- $1,150.70 / $1,944.68 / $2,862.66
| Facility | | $1,150.70 | $1,944.68 | $2,862.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,091.00 / $2,817.29 / $3,902.34
| Facility | | $2,091.00 | $2,817.29 | $3,902.34 |
- 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 |