- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,833.84 / $6,357.83 / $12,298.09
| Facility | | $4,833.84 | $6,357.83 | $12,298.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,091.67 / $2,091.67 / $2,091.67
| Facility | | $2,091.67 | $2,091.67 | $2,091.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.99 / $955.48 / $7,221.00
| Facility | | $545.99 | $955.48 | $7,221.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $1,462.46 / $2,571.84
| Facility | | $936.00 | $1,462.46 | $2,571.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |