- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $8,912.51 / $11,748.98
| Facility | | $1,479.11 | $8,912.51 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $9,549.93 / $21,379.62
| Facility | | $2,238.72 | $9,549.93 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,445.44 / $2,398.83
| Facility | | $1,288.25 | $1,445.44 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $602.56 / $2,290.87
| Facility | | $34.67 | $602.56 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,202.26 / $2,290.87
| Facility | | $524.81 | $1,202.26 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,981.07 / $6,606.93
| Facility | | $794.33 | $3,981.07 | $6,606.93 |