- 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
- $369.51 / $646.64 / $4,800.83
| Facility | | $369.51 | $646.64 | $4,800.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.00 / $1,055.75 / $2,571.84
| Facility | | $626.00 | $1,055.75 | $2,571.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |