- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $6,606.93 / $12,022.64
| Facility | | $1,513.56 | $6,606.93 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,388.44 / $16,982.44
| Facility | | $1,071.52 | $3,388.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,047.13 / $3,630.78
| Facility | | $933.25 | $1,047.13 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,659.59 / $4,466.84
| Facility | | $691.83 | $1,659.59 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,659.59 / $5,888.44
| Facility | | $691.83 | $1,659.59 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $7,244.36
| Facility | | $100.00 | $100.00 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,168.69 / $7,413.10
| Facility | | $794.33 | $4,168.69 | $7,413.10 |