- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $8,912.51 / $52,480.75
| Facility | | $2,511.89 | $8,912.51 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,413.10 / $30,199.52
| Facility | | $2,137.96 | $7,413.10 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $21,379.62
| Facility | | $1,862.09 | $1,862.09 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,090.30 / $6,760.83
| Facility | | $1,479.11 | $3,090.30 | $6,760.83 |