- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,912.19 / $8,477.27 / $20,928.72
| Facility | | $1,912.19 | $8,477.27 | $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
- $584.66 / $1,023.17 / $3,032.00
| Facility | | $584.66 | $1,023.17 | $3,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $1,351.40 / $1,719.96
| Facility | | $1,041.00 | $1,351.40 | $1,719.96 |
- 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 |