- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,552.37 / $1,894.80 / $3,621.60
| Facility | | $1,552.37 | $1,894.80 | $3,621.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,830.00 / $8,584.00 / $11,253.00
| Facility | | $5,830.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.67 / $3,114.54 / $3,670.71
| Facility | | $2,224.67 | $3,114.54 | $3,670.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.75 / $2,753.77 / $2,753.77
| Facility | | $1,845.75 | $2,753.77 | $2,753.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |