- 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
- $6,008.77 / $8,711.03 / $15,287.30
| Facility | | $6,008.77 | $8,711.03 | $15,287.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.55 / $2,149.21 / $3,057.45
| Facility | | $1,144.55 | $2,149.21 | $3,057.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,214.00 / $3,110.60 / $4,247.56
| Facility | | $2,214.00 | $3,110.60 | $4,247.56 |
- 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 |