- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.36 / $1,037.36 / $8,728.60
| Facility | | $1,037.36 | $1,037.36 | $8,728.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,748.09 / $10,188.53 / $21,650.55
| Facility | | $4,748.09 | $10,188.53 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,572.27 / $3,647.80 / $8,775.29
| Facility | | $2,572.27 | $3,647.80 | $8,775.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,091.07 / $3,334.97 / $6,909.68
| Facility | | $2,091.07 | $3,334.97 | $6,909.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,367.20 / $2,107.06 / $11,680.00
| Facility | | $1,367.20 | $2,107.06 | $11,680.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |