- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,102.00 / $4,047.33 / $7,892.00
| Facility | | $3,102.00 | $4,047.33 | $7,892.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.47 / $1,821.47 / $1,821.47
| Facility | | $1,821.47 | $1,821.47 | $1,821.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.87 / $1,382.40 / $6,887.55
| Facility | | $682.87 | $1,382.40 | $6,887.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,821.47 / $2,308.21
| Facility | | $953.00 | $1,821.47 | $2,308.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |