- 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
- $1,201.96 / $2,043.33 / $2,991.63
| Facility | | $1,201.96 | $2,043.33 | $2,991.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,205.00 / $2,921.38 / $4,081.95
| Facility | | $2,205.00 | $2,921.38 | $4,081.95 |
- 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 |