- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,152.06 / $8,355.33 / $19,276.96
| Facility | | $3,152.06 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.03 / $5,947.70 / $11,504.78
| Facility | | $4,522.03 | $5,947.70 | $11,504.78 |
- 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
- $431.09 / $754.41 / $5,405.32
| Facility | | $431.09 | $754.41 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.01 / $1,156.77 / $2,961.89
| Facility | | $867.01 | $1,156.77 | $2,961.89 |
- 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 |