- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $6,025.60 / $11,748.98
| Facility | | $1,122.02 | $6,025.60 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,570.88 / $16,982.44
| Facility | | $2,238.72 | $4,570.88 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $616.60 / $691.83
| Facility | | $588.84 | $616.60 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,370.32 / $26,302.68
| Facility | | $1,202.26 | $5,370.32 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $6,165.95
| Facility | | $100.00 | $100.00 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $5,754.40 / $9,120.11
| Facility | | $2,951.21 | $5,754.40 | $9,120.11 |