- 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
- $8,383.91 / $11,362.35 / $21,330.03
| Facility | | $8,383.91 | $11,362.35 | $21,330.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,296.46 / $2,219.58 / $7,856.00
| Facility | | $1,296.46 | $2,219.58 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,397.00 / $2,936.66 / $4,005.31
| Facility | | $2,397.00 | $2,936.66 | $4,005.31 |
- 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 |