- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,611.47 / $24,068.03
| Facility | | $4,241.22 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,522.85 / $8,579.33 / $16,595.18
| Facility | | $6,522.85 | $8,579.33 | $16,595.18 |
- 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
- $663.81 / $1,161.67 / $5,402.75
| Facility | | $663.81 | $1,161.67 | $5,402.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,332.80 / $1,932.00 / $2,571.84
| Facility | | $1,332.80 | $1,932.00 | $2,571.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |