- 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
- $9,454.19 / $12,812.86 / $24,053.01
| Facility | | $9,454.19 | $12,812.86 | $24,053.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,230.69 / $3,800.43 / $7,856.00
| Facility | | $2,230.69 | $3,800.43 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,918.00 / $4,986.14 / $7,004.37
| Facility | | $3,918.00 | $4,986.14 | $7,004.37 |
- 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 |