- 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
- $7,653.53 / $11,095.47 / $19,471.83
| Facility | | $7,653.53 | $11,095.47 | $19,471.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.55 / $251.21 / $383.45
| Facility | | $143.55 | $251.21 | $383.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.00 / $352.98 / $508.91
| Facility | | $278.00 | $352.98 | $508.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |