- 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
- $12,669.97 / $18,367.90 / $32,234.47
| Facility | | $12,669.97 | $18,367.90 | $32,234.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.13 / $2,745.72 / $3,827.55
| Facility | | $1,615.13 | $2,745.72 | $3,827.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,823.00 / $3,986.15 / $5,322.98
| Facility | | $2,823.00 | $3,986.15 | $5,322.98 |
- 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 |