- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.83 / $8,042.03 / $19,276.96
| Facility | | $2,222.83 | $8,042.03 | $19,276.96 |
- 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
- $6,764.76 / $6,764.76 / $6,764.76
| Facility | | $6,764.76 | $6,764.76 | $6,764.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.45 / $1,094.18 / $9,496.00
| Facility | | $589.45 | $1,094.18 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.00 / $1,491.81 / $8,561.79
| Facility | | $1,008.00 | $1,491.81 | $8,561.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $9,094.60 / $10,575.11
| Facility | | $6,777.00 | $9,094.60 | $10,575.11 |