- 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
- $6,416.80 / $9,302.56 / $16,325.39
| Facility | | $6,416.80 | $9,302.56 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $975.66 / $1,658.62 / $2,424.23
| Facility | | $975.66 | $1,658.62 | $2,424.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,754.00 / $2,423.57 / $3,234.67
| Facility | | $1,754.00 | $2,423.57 | $3,234.67 |
- 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 |