- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $8,912.51 / $11,748.98
| Facility | | $1,230.27 | $8,912.51 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,456.54 / $15,135.61
| Facility | | $1,698.24 | $6,456.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,071.52 / $1,380.38
| Facility | | $1,047.13 | $1,071.52 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,230.27 / $1,862.09
| Facility | | $34.67 | $1,230.27 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $1,862.09 / $21,379.62
| Facility | | $426.58 | $1,862.09 | $21,379.62 |
- 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
- $575.44 / $2,691.53 / $6,760.83
| Facility | | $575.44 | $2,691.53 | $6,760.83 |