- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $7,119.04 / $19,276.96
| Facility | | $4,241.22 | $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
- $392.18 / $705.92 / $5,405.32
| Facility | | $392.18 | $705.92 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $788.30 / $1,046.63 / $2,961.89
| Facility | | $788.30 | $1,046.63 | $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 |