- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $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
- $3,080.39 / $3,080.39 / $3,080.39
| Facility | | $3,080.39 | $3,080.39 | $3,080.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.93 / $1,195.13 / $5,405.32
| Facility | | $682.93 | $1,195.13 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.00 / $1,699.89 / $3,306.28
| Facility | | $1,272.00 | $1,699.89 | $3,306.28 |
- 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 |