- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,025.60 / $9,549.93
| Facility | | $1,288.25 | $6,025.60 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $2,398.83 / $4,677.35
| Facility | | $741.31 | $2,398.83 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,248.07 / $9,549.93
| Facility | | $1,047.13 | $5,248.07 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $1,230.27
| Facility | | $602.56 | $602.56 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $691.83
| Facility | | $588.84 | $588.84 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,630.78 / $10,471.29
| Facility | | $1,258.93 | $3,630.78 | $10,471.29 |