- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,876.70 / $10,431.19 / $20,928.72
| Facility | | $3,876.70 | $10,431.19 | $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
- $731.26 / $1,316.27 / $5,405.32
| Facility | | $731.26 | $1,316.27 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,285.00 / $1,856.61 / $2,997.97
| Facility | | $1,285.00 | $1,856.61 | $2,997.97 |
- 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 |