- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,752.78 / $9,544.15 / $20,928.72
| Facility | | $3,752.78 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- 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
- $531.29 / $956.34 / $8,163.00
| Facility | | $531.29 | $956.34 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $865.21 / $1,431.58 / $2,961.89
| Facility | | $865.21 | $1,431.58 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |