- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,172.55 / $8,477.27 / $19,276.96
| Facility | | $3,172.55 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,180.02 / $5,453.87 / $10,634.64
| Facility | | $4,180.02 | $5,453.87 | $10,634.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,141.50 / $3,141.50 / $3,141.50
| Facility | | $3,141.50 | $3,141.50 | $3,141.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.74 / $1,443.52 / $7,934.00
| Facility | | $641.74 | $1,443.52 | $7,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,781.62 / $3,987.81
| Facility | | $1,089.00 | $1,781.62 | $3,987.81 |
- 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 |