- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,585.78 / $22,908.68
| Facility | | $3,090.30 | $7,585.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $870.96
| Facility | | $758.58 | $758.58 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,311.31 / $17,782.79
| Facility | | $1,621.81 | $3,311.31 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,162.28 / $3,388.44
| Facility | | $2,398.83 | $3,162.28 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,290.87
| Facility | | $2,187.76 | $2,187.76 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $36,307.81 / $70,794.58
| Facility | | $28,183.83 | $36,307.81 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $38,018.94 / $72,443.60
| Facility | | $4,265.80 | $38,018.94 | $72,443.60 |