- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,890.45 / $12,882.50
| Facility | | $1,096.48 | $3,890.45 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,801.89 / $7,943.28
| Facility | | $2,089.30 | $3,801.89 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,818.38 / $2,818.38
| Facility | | $501.19 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,862.09 / $2,344.23
| Facility | | $912.01 | $1,862.09 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $33,884.42 / $33,884.42
| Facility | | $7,943.28 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $691.83 / $2,137.96
| Facility | | $512.86 | $691.83 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $660.69 / $1,148.15
| Facility | | $501.19 | $660.69 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,981.07 / $8,511.38
| Facility | | $1,380.38 | $3,981.07 | $8,511.38 |