- 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
- $1,279.82 / $2,162.90 / $3,185.67
| Facility | | $1,279.82 | $2,162.90 | $3,185.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,338.00 / $3,132.43 / $4,409.09
| Facility | | $2,338.00 | $3,132.43 | $4,409.09 |
- 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 |