- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,697.93 / $9,185.68 / $20,928.72
| Facility | | $1,697.93 | $9,185.68 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.14 / $2,237.02 / $3,753.35
| Facility | | $467.14 | $2,237.02 | $3,753.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,012.63 / $2,961.89 / $4,931.27
| Facility | | $1,012.63 | $2,961.89 | $4,931.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |