- 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
- $1,378.24 / $2,329.23 / $3,403.02
| Facility | | $1,378.24 | $2,329.23 | $3,403.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,463.00 / $3,401.73 / $4,615.60
| Facility | | $2,463.00 | $3,401.73 | $4,615.60 |
- 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 |