- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,100.37 / $20,928.72
| Facility | | $4,241.22 | $10,100.37 | $20,928.72 |
- 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
- $734.70 / $1,322.46 / $5,405.32
| Facility | | $734.70 | $1,322.46 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,285.00 / $2,104.81 / $3,000.40
| Facility | | $1,285.00 | $2,104.81 | $3,000.40 |
- 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 |