- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $4,897.79 / $13,182.57
| Facility | | $1,258.93 | $4,897.79 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,762.47 / $14,791.08
| Facility | | $4,265.80 | $7,762.47 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $6,025.60 / $13,182.57
| Facility | | $1,995.26 | $6,025.60 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $7,079.46 / $7,079.46
| Facility | | $794.33 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,943.28 / $7,943.28
| Facility | | $4,073.80 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $50,118.72 / $50,118.72
| Facility | | $16,218.10 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,737.80 / $8,511.38
| Facility | | $870.96 | $1,737.80 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,148.15 / $1,995.26
| Facility | | $794.33 | $1,148.15 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,760.83 / $13,803.84
| Facility | | $2,187.76 | $6,760.83 | $13,803.84 |