- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,463.73 / $5,916.40 / $21,917.86
| Facility | | $1,463.73 | $5,916.40 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $20,286.13
| Facility | | $2,961.46 | $9,172.83 | $20,286.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $1,075.31 / $3,740.43
| Facility | | $883.20 | $1,075.31 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.40 / $1,643.86 / $3,280.24
| Facility | | $810.40 | $1,643.86 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.19 / $1,432.46 / $1,593.93
| Facility | | $1,044.19 | $1,432.46 | $1,593.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.25 / $1,079.95 / $2,961.46
| Facility | | $986.25 | $1,079.95 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,013.44 / $9,167.59 / $17,546.59
| Facility | | $6,013.44 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,129.00 / $11,941.00
| Facility | | $2,155.00 | $3,129.00 | $11,941.00 |