- 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
- $1,243.86 / $2,114.58 / $3,319.34
| Facility | | $1,243.86 | $2,114.58 | $3,319.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,498.96 / $3,034.91 / $4,296.50
| Facility | | $2,498.96 | $3,034.91 | $4,296.50 |
- 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 |