- 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
- $3,009.30 / $3,958.05 / $7,656.16
| Facility | | $3,009.30 | $3,958.05 | $7,656.16 |
- 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
- $170.24 / $306.43 / $4,217.00
| Facility | | $170.24 | $306.43 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.34 / $518.83 / $1,757.37
| Facility | | $343.34 | $518.83 | $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 |