- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,586.28 / $7,119.04 / $19,276.96
| Facility | | $1,586.28 | $7,119.04 | $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
- $491.09 / $859.41 / $5,405.32
| Facility | | $491.09 | $859.41 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $960.00 / $1,316.00 / $2,961.89
| Facility | | $960.00 | $1,316.00 | $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 |