- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,303.03 / $1,303.03 / $25,569.25
| Facility | | $1,303.03 | $1,303.03 | $25,569.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,462.63 / $5,213.67 / $10,098.06
| Facility | | $2,462.63 | $5,213.67 | $10,098.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,144.24 / $4,461.21 / $10,732.06
| Facility | | $3,144.24 | $4,461.21 | $10,732.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,858.40 / $4,078.62 / $8,450.44
| Facility | | $2,858.40 | $4,078.62 | $8,450.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,358.21 / $2,433.48 / $4,974.00
| Facility | | $1,358.21 | $2,433.48 | $4,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |