- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,029.65 / $8,477.27 / $19,276.96
| Facility | | $3,029.65 | $8,477.27 | $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
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.26 / $1,190.69 / $4,754.80
| Facility | | $690.26 | $1,190.69 | $4,754.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,057.00 / $1,404.03 / $2,020.28
| Facility | | $1,057.00 | $1,404.03 | $2,020.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,325.00 / $8,816.00
| Facility | | $4,700.00 | $6,325.00 | $8,816.00 |