- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,888.44 / $12,882.50
| Facility | | $1,047.13 | $5,888.44 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,890.45 / $15,135.61
| Facility | | $1,698.24 | $3,890.45 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $794.33 / $891.25
| Facility | | $660.69 | $794.33 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,096.48 / $21,379.62
| Facility | | $776.25 | $1,096.48 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $4,073.80 / $8,709.64
| Facility | | $1,905.46 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $1,513.56 / $3,981.07
| Facility | | $100.00 | $1,513.56 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,025.60 / $9,332.54
| Facility | | $2,818.38 | $6,025.60 | $9,332.54 |