- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.36 / $9,185.68 / $20,928.72
| Facility | | $1,288.36 | $9,185.68 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,949.61 / $3,879.54 / $7,504.28
| Facility | | $2,949.61 | $3,879.54 | $7,504.28 |
- 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
- $361.81 / $651.26 / $4,217.00
| Facility | | $361.81 | $651.26 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.00 / $1,066.48 / $1,597.11
| Facility | | $711.00 | $1,066.48 | $1,597.11 |
- 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 |