- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $8,477.27 / $19,276.96
| Facility | | $4,241.22 | $8,477.27 | $19,276.96 |
- 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
- $533.21 / $1,148.52 / $6,887.55
| Facility | | $533.21 | $1,148.52 | $6,887.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.61 / $1,482.72 / $2,308.21
| Facility | | $926.61 | $1,482.72 | $2,308.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,839.11 / $3,875.52 / $7,772.00
| Facility | | $2,839.11 | $3,875.52 | $7,772.00 |