- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $3,890.45 / $14,454.40
| Facility | | $1,148.15 | $3,890.45 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,265.80 / $10,471.29
| Facility | | $2,570.40 | $4,265.80 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $2,187.76 / $2,238.72
| Facility | | $79.43 | $2,187.76 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $38,018.94
| Facility | | $54.95 | $56.23 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,162.28 / $5,754.40
| Facility | | $1,995.26 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,162.28 / $5,370.32
| Facility | | $2,290.87 | $3,162.28 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,964.78 / $23,988.33
| Facility | | $4,570.88 | $10,964.78 | $23,988.33 |