- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,454.25 / $8,355.33 / $19,276.96
| Facility | | $1,454.25 | $8,355.33 | $19,276.96 |
- 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
- $456.68 / $799.19 / $5,405.32
| Facility | | $456.68 | $799.19 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $790.00 / $1,149.19 / $2,961.89
| Facility | | $790.00 | $1,149.19 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |