- 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
- $3,678.00 / $6,117.07 / $9,198.25
| Facility | | $3,678.00 | $6,117.07 | $9,198.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,068.40 / $9,149.85 / $12,842.48
| Facility | | $7,068.40 | $9,149.85 | $12,842.48 |
- 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 |