- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $9,544.15 / $20,928.72
| Facility | | $4,241.22 | $9,544.15 | $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
- $370.26 / $666.47 / $3,044.00
| Facility | | $370.26 | $666.47 | $3,044.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.00 / $1,088.09 / $1,597.11
| Facility | | $694.00 | $1,088.09 | $1,597.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |