- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $6,606.93 / $10,964.78
| Facility | | $1,412.54 | $6,606.93 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $8,317.64 / $11,748.98
| Facility | | $6,606.93 | $8,317.64 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $5,888.44 / $10,964.78
| Facility | | $1,122.02 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $851.14
| Facility | | $707.95 | $707.95 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,570.40 / $6,760.83
| Facility | | $660.69 | $2,570.40 | $6,760.83 |