- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,876.70 / $6,732.07 / $19,276.96
| Facility | | $3,876.70 | $6,732.07 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,094.34 / $5,385.17 / $10,416.66
| Facility | | $4,094.34 | $5,385.17 | $10,416.66 |
- 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
- $334.09 / $601.36 / $5,405.32
| Facility | | $334.09 | $601.36 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.00 / $984.81 / $2,961.89
| Facility | | $611.00 | $984.81 | $2,961.89 |
- 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 |