- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,876.70 / $8,477.27 / $21,899.37
| Facility | | $3,876.70 | $8,477.27 | $21,899.37 |
- 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
- $667.97 / $1,228.93 / $4,803.10
| Facility | | $667.97 | $1,228.93 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $939.91 / $1,685.52 / $2,961.89
| Facility | | $939.91 | $1,685.52 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $5,356.00 / $7,934.00
| Facility | | $2,529.66 | $5,356.00 | $7,934.00 |