- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,943.28 / $28,183.83
| Facility | | $2,137.96 | $7,943.28 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $23,988.33
| Facility | | $707.95 | $870.96 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $2,290.87 / $21,379.62
| Facility | | $1,174.90 | $2,290.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,137.96 / $2,290.87
| Facility | | $1,548.82 | $2,137.96 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,548.82 / $6,760.83
| Facility | | $1,513.56 | $1,548.82 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $37,153.52 / $70,794.58
| Facility | | $26,915.35 | $37,153.52 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $38,018.94 / $72,443.60
| Facility | | $2,454.71 | $38,018.94 | $72,443.60 |