- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.57 / $1,300.57 / $21,586.61
| Facility | | $1,300.57 | $1,300.57 | $21,586.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,440.85 / $16,192.78 / $36,247.94
| Facility | | $6,440.85 | $16,192.78 | $36,247.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,298.31 / $4,677.41 / $11,252.14
| Facility | | $3,298.31 | $4,677.41 | $11,252.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,681.29 / $4,276.27 / $8,859.95
| Facility | | $2,681.29 | $4,276.27 | $8,859.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,889.63 / $2,739.44 / $12,051.00
| Facility | | $1,889.63 | $2,739.44 | $12,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |