- 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 / $1,792.20 / $3,364.42
| Facility | | $1,322.41 | $1,792.20 | $3,364.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.45 / $492.06 / $2,291.44
| Facility | | $278.45 | $492.06 | $2,291.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.29 / $649.05 / $912.02
| Facility | | $522.29 | $649.05 | $912.02 |
- 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 |