- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,943.28 / $20,892.96
| Facility | | $2,818.38 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $758.58 / $870.96
| Facility | | $707.95 | $758.58 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,235.94 / $16,218.10
| Facility | | $1,698.24 | $3,235.94 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,090.30 / $3,311.31
| Facility | | $2,398.83 | $3,090.30 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,238.72
| Facility | | $2,187.76 | $2,187.76 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $18,620.87 / $35,481.34
| Facility | | $14,125.38 | $18,620.87 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $21,379.62 / $41,686.94
| Facility | | $4,265.80 | $21,379.62 | $41,686.94 |