- 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
- $2,204.60 / $3,335.06 / $7,856.00
| Facility | | $2,204.60 | $3,335.06 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,894.04 / $5,016.68 / $7,004.72
| Facility | | $3,894.04 | $5,016.68 | $7,004.72 |
- 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 |