- 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
- $664.72 / $1,123.38 / $1,629.66
| Facility | | $664.72 | $1,123.38 | $1,629.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,177.00 / $1,648.46 / $2,202.16
| Facility | | $1,177.00 | $1,648.46 | $2,202.16 |
- 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 |