- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,172.55 / $8,355.33 / $19,276.96
| Facility | | $3,172.55 | $8,355.33 | $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
- $463.93 / $858.27 / $5,405.32
| Facility | | $463.93 | $858.27 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.01 / $1,316.00 / $2,961.89
| Facility | | $937.01 | $1,316.00 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,178.00 / $8,632.00
| Facility | | $4,700.00 | $6,178.00 | $8,632.00 |