- 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
- $8,501.19 / $11,521.30 / $21,628.42
| Facility | | $8,501.19 | $11,521.30 | $21,628.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.13 / $1,466.04 / $7,856.00
| Facility | | $957.13 | $1,466.04 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,699.75 / $2,170.87 / $3,032.56
| Facility | | $1,699.75 | $2,170.87 | $3,032.56 |
- 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 |