- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,168.69 / $14,125.38
| Facility | | $1,096.48 | $4,168.69 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,762.47 / $15,135.61
| Facility | | $4,265.80 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $33,884.42 / $33,884.42
| Facility | | $16,595.87 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,148.15 / $6,456.54
| Facility | | $676.08 | $1,148.15 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $933.25 / $1,584.89
| Facility | | $660.69 | $933.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,760.83 / $13,803.84
| Facility | | $2,187.76 | $6,760.83 | $13,803.84 |