- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,144.58 / $7,119.04 / $19,276.96
| Facility | | $2,144.58 | $7,119.04 | $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
- $491.27 / $884.29 / $5,405.32
| Facility | | $491.27 | $884.29 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $994.71 / $1,316.00 / $2,961.89
| Facility | | $994.71 | $1,316.00 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.98 / $5,341.00 / $8,632.00
| Facility | | $4,038.98 | $5,341.00 | $8,632.00 |