- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,884.03 / $5,623.41
| Facility | | $1,318.26 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,630.78 / $28,840.32
| Facility | | $812.83 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $645.65 / $2,691.53
| Facility | | $588.84 | $645.65 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,096.48 / $7,079.46
| Facility | | $501.19 | $1,096.48 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,090.30 / $5,370.32
| Facility | | $3,019.95 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,630.78 / $28,840.32
| Facility | | $812.83 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,548.13 / $8,511.38
| Facility | | $676.08 | $3,548.13 | $8,511.38 |