- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $9,544.15 / $20,928.72
| Facility | | $4,241.22 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.31 / $3,250.33 / $6,101.70
| Facility | | $2,398.31 | $3,250.33 | $6,101.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.85 / $811.80 / $4,766.80
| Facility | | $499.85 | $811.80 | $4,766.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $939.38 / $1,211.71 / $2,691.59
| Facility | | $939.38 | $1,211.71 | $2,691.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |