- 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
- $8,578.44 / $11,625.99 / $21,824.96
| Facility | | $8,578.44 | $11,625.99 | $21,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.88 / $2,145.40 / $7,772.00
| Facility | | $1,326.88 | $2,145.40 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $2,980.33 / $4,213.04
| Facility | | $2,266.00 | $2,980.33 | $4,213.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |