- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,876.70 / $11,611.47 / $24,068.03
| Facility | | $3,876.70 | $11,611.47 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,306.43 / $5,664.13 / $10,956.25
| Facility | | $4,306.43 | $5,664.13 | $10,956.25 |
- 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
- $462.23 / $808.90 / $4,803.10
| Facility | | $462.23 | $808.90 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.00 / $1,361.92 / $2,961.89
| Facility | | $924.00 | $1,361.92 | $2,961.89 |
- 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 |