- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $4,168.69 / $13,803.84
| Facility | | $1,174.90 | $4,168.69 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $6,165.95 / $11,748.98
| Facility | | $3,548.13 | $6,165.95 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,467.37 / $3,467.37
| Facility | | $794.33 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,691.53
| Facility | | $2,570.40 | $2,570.40 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $33,884.42 / $33,884.42
| Facility | | $11,748.98 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,621.81 / $7,585.78
| Facility | | $891.25 | $1,621.81 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,258.93 / $2,398.83
| Facility | | $891.25 | $1,258.93 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,606.93 / $13,803.84
| Facility | | $2,187.76 | $6,606.93 | $13,803.84 |