- 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
- $486.52 / $1,037.38 / $6,887.55
| Facility | | $486.52 | $1,037.38 | $6,887.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.96 / $1,353.51 / $2,308.21
| Facility | | $827.96 | $1,353.51 | $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 |