- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,560.59 / $7,682.00 / $20,680.40
| Facility | | $1,560.59 | $7,682.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.13 / $9,167.59 / $17,907.41
| Facility | | $5,646.13 | $9,167.59 | $17,907.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $3,740.43
| Facility | | $714.97 | $870.49 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $892.89 / $1,790.80 / $3,280.24
| Facility | | $892.89 | $1,790.80 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.76 / $1,626.76 / $1,712.52
| Facility | | $1,187.76 | $1,626.76 | $1,712.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.25 / $1,131.14 / $2,961.46
| Facility | | $986.25 | $1,131.14 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,145.87 / $9,167.59 / $17,546.59
| Facility | | $6,145.87 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,297.00 / $11,941.00
| Facility | | $2,155.00 | $3,297.00 | $11,941.00 |