- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,019.95 / $10,715.19
| Facility | | $1,096.48 | $3,019.95 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,388.44 / $13,489.63
| Facility | | $954.99 | $3,388.44 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $2,344.23
| Facility | | $676.08 | $741.31 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,202.26 / $2,818.38
| Facility | | $380.19 | $1,202.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,202.26 / $3,801.89
| Facility | | $380.19 | $1,202.26 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $4,677.35
| Facility | | $100.00 | $100.00 | $4,677.35 |
- 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 |