- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.50 / $6,732.07 / $19,276.96
| Facility | | $1,095.50 | $6,732.07 | $19,276.96 |
- 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
- $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
- $638.45 / $1,117.29 / $4,803.10
| Facility | | $638.45 | $1,117.29 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,578.09 / $2,961.89
| Facility | | $1,089.00 | $1,578.09 | $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 |