- 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
- $9,990.74 / $13,540.02 / $25,418.08
| Facility | | $9,990.74 | $13,540.02 | $25,418.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.82 / $2,501.07 / $9,815.00
| Facility | | $1,417.82 | $2,501.07 | $9,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,138.00 / $3,155.00 / $4,149.31
| Facility | | $2,138.00 | $3,155.00 | $4,149.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |