- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,741.96 / $1,844.64 / $3,661.07
| Facility | | $1,741.96 | $1,844.64 | $3,661.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,047.17 / $3,462.77 / $10,540.75
| Facility | | $2,047.17 | $3,462.77 | $10,540.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,158.79 / $3,213.98 / $3,213.98
| Facility | | $2,158.79 | $3,213.98 | $3,213.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $16,306.62
| Facility | | $55.00 | $55.00 | $16,306.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,844.64 / $2,473.23 / $4,608.22
| Facility | | $1,844.64 | $2,473.23 | $4,608.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,863.16 / $2,507.82 / $4,725.91
| Facility | | $1,863.16 | $2,507.82 | $4,725.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |