- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,677.35 / $10,232.93
| Facility | | $1,230.27 | $4,677.35 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,995.26 / $8,912.51
| Facility | | $1,230.27 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,862.09 / $50,118.72
| Facility | | $1,513.56 | $1,862.09 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,621.81 / $3,548.13
| Facility | | $977.24 | $1,621.81 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $50,118.72 / $75,857.76
| Facility | | $851.14 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,365.16 / $9,549.93
| Facility | | $2,137.96 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,023.29 / $3,388.44
| Facility | | $707.95 | $1,023.29 | $3,388.44 |