- 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
- $2,323.11 / $3,833.13 / $5,407.21
| Facility | | $2,323.11 | $3,833.13 | $5,407.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,847.00 / $5,814.36 / $7,495.72
| Facility | | $3,847.00 | $5,814.36 | $7,495.72 |
- 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 |