- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,235.94 / $5,370.32
| Facility | | $1,380.38 | $3,235.94 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,897.79 / $33,884.42
| Facility | | $1,819.70 | $4,897.79 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $3,019.95
| Facility | | $1,318.26 | $1,318.26 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,995.26 / $7,079.46
| Facility | | $707.95 | $1,995.26 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,897.79 / $33,884.42
| Facility | | $1,995.26 | $4,897.79 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $12,302.69
| Facility | | $1,862.09 | $4,265.80 | $12,302.69 |