- 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
- $9,426.81 / $13,666.22 / $23,983.33
| Facility | | $9,426.81 | $13,666.22 | $23,983.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.50 / $499.63 / $826.96
| Facility | | $285.50 | $499.63 | $826.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.00 / $709.61 / $1,013.64
| Facility | | $557.00 | $709.61 | $1,013.64 |
- 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 |