- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,507.81 / $1,983.18 / $3,836.12
| Facility | | $1,507.81 | $1,983.18 | $3,836.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.13 / $459.04 / $4,217.00
| Facility | | $248.13 | $459.04 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.07 / $719.52 / $1,757.37
| Facility | | $503.07 | $719.52 | $1,757.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |