- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,762.47 / $20,892.96
| Facility | | $2,884.03 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,122.02
| Facility | | $1,122.02 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $4,570.88 / $5,754.40
| Facility | | $2,951.21 | $4,570.88 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,466.84 / $4,570.88
| Facility | | $3,548.13 | $4,466.84 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,090.30 / $3,090.30
| Facility | | $1,995.26 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,445.44 / $4,786.30
| Facility | | $1,288.25 | $1,445.44 | $4,786.30 |