- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $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
- $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
- $314.80 / $583.70 / $4,803.10
| Facility | | $314.80 | $583.70 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.00 / $925.97 / $2,961.89
| Facility | | $571.00 | $925.97 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,679.00 / $3,167.00 / $7,772.00
| Facility | | $2,679.00 | $3,167.00 | $7,772.00 |