- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,786.30 / $11,220.18
| Facility | | $2,290.87 | $4,786.30 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $30,902.95 / $37,153.52
| Facility | | $10,715.19 | $30,902.95 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $11,220.18 / $16,595.87
| Facility | | $10,964.78 | $11,220.18 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $1,737.80 / $2,884.03
| Facility | | $1,737.80 | $1,737.80 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $10,471.29 / $16,982.44
| Facility | | $4,677.35 | $10,471.29 | $16,982.44 |