- 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
- $9,584.12 / $13,894.28 / $24,383.56
| Facility | | $9,584.12 | $13,894.28 | $24,383.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $951.65 / $1,608.29 / $2,357.92
| Facility | | $951.65 | $1,608.29 | $2,357.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,709.00 / $2,346.41 / $3,163.44
| Facility | | $1,709.00 | $2,346.41 | $3,163.44 |
- 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 |