- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,413.75 / $1,664.15 / $2,258.80
| Facility | | $1,413.75 | $1,664.15 | $2,258.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.00 / $11,471.00 / $22,581.03
| Facility | | $4,793.00 | $11,471.00 | $22,581.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,770.90 / $1,770.90 / $37,499.62
| Facility | | $1,770.90 | $1,770.90 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,812.00 / $7,378.61
| Facility | | $332.00 | $1,812.00 | $7,378.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,173.28 / $1,173.28 / $1,173.28
| Facility | | $1,173.28 | $1,173.28 | $1,173.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $54,793.00
| Facility | | $555.00 | $597.00 | $54,793.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,497.15 / $1,497.15 / $5,795.77
| Facility | | $1,497.15 | $1,497.15 | $5,795.77 |