- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,570.88 / $12,882.50
| Facility | | $1,380.38 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,489.63 / $25,703.96
| Facility | | $7,585.78 | $13,489.63 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $15,488.17 / $15,488.17
| Facility | | $1,023.29 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $10,232.93 / $22,387.21
| Facility | | $2,818.38 | $10,232.93 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,905.46 / $7,943.28
| Facility | | $1,096.48 | $1,905.46 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,513.56 / $2,570.40
| Facility | | $1,096.48 | $1,513.56 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,964.78 / $22,908.68
| Facility | | $4,570.88 | $10,964.78 | $22,908.68 |