- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,235.94 / $10,964.78
| Facility | | $1,621.81 | $3,235.94 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,762.47 / $13,803.84
| Facility | | $3,890.45 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $10,964.78
| Facility | | $1,949.84 | $1,949.84 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,290.87 / $7,762.47
| Facility | | $34.67 | $2,290.87 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $3,235.94
| Facility | | $524.81 | $1,445.44 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $1,288.25
| Facility | | $1,288.25 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $50,118.72 / $75,857.76
| Facility | | $1,412.54 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,495.41 / $13,803.84
| Facility | | $2,238.72 | $5,495.41 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,659.59 / $4,897.79
| Facility | | $1,122.02 | $1,659.59 | $4,897.79 |