- 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
- $14,877.26 / $21,567.85 / $37,850.17
| Facility | | $14,877.26 | $21,567.85 | $37,850.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $893.85 / $1,510.61 / $2,187.23
| Facility | | $893.85 | $1,510.61 | $2,187.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $2,210.31 / $2,935.90
| Facility | | $1,565.00 | $2,210.31 | $2,935.90 |
- 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 |