- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,312.63 / $3,041.74 / $5,883.72
| Facility | | $2,312.63 | $3,041.74 | $5,883.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.16 / $266.27 / $4,803.10
| Facility | | $152.16 | $266.27 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.91 / $443.16 / $2,961.89
| Facility | | $305.91 | $443.16 | $2,961.89 |
- 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 |