- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.41 / $1,739.33 / $3,364.42
| Facility | | $1,322.41 | $1,739.33 | $3,364.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.87 / $169.69 / $1,775.00
| Facility | | $120.87 | $169.69 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.00 / $236.01 / $317.36
| Facility | | $184.00 | $236.01 | $317.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |