- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,053.22 / $8,355.33 / $19,276.96
| Facility | | $1,053.22 | $8,355.33 | $19,276.96 |
- 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
- $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
- $436.64 / $764.12 / $5,405.32
| Facility | | $436.64 | $764.12 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.00 / $1,176.76 / $2,961.89
| Facility | | $852.00 | $1,176.76 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |