- 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
- $1,728.33 / $2,273.23 / $4,397.14
| Facility | | $1,728.33 | $2,273.23 | $4,397.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.44 / $432.16 / $3,227.00
| Facility | | $273.44 | $432.16 | $3,227.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.49 / $531.25 / $618.14
| Facility | | $427.49 | $531.25 | $618.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |