- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.51 / $9,858.65 / $19,069.81
| Facility | | $7,495.51 | $9,858.65 | $19,069.81 |
- 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
- $406.71 / $714.06 / $7,221.00
| Facility | | $406.71 | $714.06 | $7,221.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.00 / $1,194.98 / $2,961.89
| Facility | | $694.00 | $1,194.98 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $7,221.00 / $8,816.00
| Facility | | $2,529.66 | $7,221.00 | $8,816.00 |