- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493.40 / $863.45 / $4,236.79
| Facility | | $493.40 | $863.45 | $4,236.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,331.51 / $2,256.42
| Facility | | $953.00 | $1,331.51 | $2,256.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |