- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $6,025.60 / $18,620.87
| Facility | | $1,380.38 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $2,884.03
| Facility | | $645.65 | $645.65 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,513.56 / $5,888.44
| Facility | | $870.96 | $1,513.56 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,348.96 / $1,445.44
| Facility | | $977.24 | $1,348.96 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $954.99 / $1,000.00
| Facility | | $954.99 | $954.99 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,606.93 / $12,589.25
| Facility | | $4,466.84 | $6,606.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $7,244.36 / $13,182.57
| Facility | | $1,380.38 | $7,244.36 | $13,182.57 |