- 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
- $10,176.85 / $13,792.24 / $25,891.56
| Facility | | $10,176.85 | $13,792.24 | $25,891.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,497.65 / $2,274.73 / $7,856.00
| Facility | | $1,497.65 | $2,274.73 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,635.13 / $3,274.73 / $4,711.52
| Facility | | $2,635.13 | $3,274.73 | $4,711.52 |
- 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 |