- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,715.35 / $12,882.50
| Facility | | $1,023.29 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,290.87 / $4,570.88
| Facility | | $1,348.96 | $2,290.87 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $691.83 / $691.83
| Facility | | $79.43 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $33,884.42 / $33,884.42
| Facility | | $4,786.30 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,122.02 / $4,265.80
| Facility | | $724.44 | $1,122.02 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,047.13 / $1,659.59
| Facility | | $724.44 | $1,047.13 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |