- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,165.95 / $9,772.37
| Facility | | $1,288.25 | $6,165.95 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,370.32 / $9,772.37
| Facility | | $1,047.13 | $5,370.32 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $724.44 / $776.25
| Facility | | $691.83 | $724.44 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,467.37 / $7,413.10
| Facility | | $1,348.96 | $3,467.37 | $7,413.10 |