- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.00 / $6,499.33 / $20,061.54
| Facility | | $1,181.00 | $6,499.33 | $20,061.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $14,802.76
| Facility | | $530.04 | $530.04 | $14,802.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,072.00 / $1,342.98 / $2,161.87
| Facility | | $1,072.00 | $1,342.98 | $2,161.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,321.75 / $42,699.48 / $48,920.50
| Facility | | $5,321.75 | $42,699.48 | $48,920.50 |