- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $12,882.50
| Facility | | $1,071.52 | $3,890.45 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,162.28 / $6,606.93
| Facility | | $1,819.70 | $3,162.28 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $851.14
| Facility | | $831.76 | $831.76 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,318.26
| Facility | | $1,258.93 | $1,258.93 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $42,657.95 / $42,657.95
| Facility | | $6,456.54 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,318.26 / $6,165.95
| Facility | | $891.25 | $1,318.26 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,096.48 / $1,737.80
| Facility | | $870.96 | $1,096.48 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $4,073.80 / $8,709.64
| Facility | | $1,258.93 | $4,073.80 | $8,709.64 |