- 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
- $4,070.46 / $5,516.52 / $10,355.91
| Facility | | $4,070.46 | $5,516.52 | $10,355.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.61 / $1,421.45 / $6,673.10
| Facility | | $796.61 | $1,421.45 | $6,673.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $1,778.74 / $2,526.78
| Facility | | $1,346.00 | $1,778.74 | $2,526.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |