- 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
- $3,309.15 / $5,025.60 / $7,856.00
| Facility | | $3,309.15 | $5,025.60 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,819.09 / $7,549.43 / $10,510.72
| Facility | | $5,819.09 | $7,549.43 | $10,510.72 |
- 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 |