- 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
- $8,283.48 / $11,226.25 / $21,074.53
| Facility | | $8,283.48 | $11,226.25 | $21,074.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,431.18 / $2,458.54 / $7,856.00
| Facility | | $1,431.18 | $2,458.54 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,526.00 / $3,197.21 / $4,494.63
| Facility | | $2,526.00 | $3,197.21 | $4,494.63 |
- 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 |