- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $7,943.28 / $22,908.68
| Facility | | $2,089.30 | $7,943.28 | $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
- $1,174.90 / $2,238.72 / $9,549.93
| Facility | | $1,174.90 | $2,238.72 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,137.96 / $2,238.72
| Facility | | $1,621.81 | $2,137.96 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,548.82 / $4,365.16
| Facility | | $1,479.11 | $1,548.82 | $4,365.16 |
- 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 / $21,379.62 / $41,686.94
| Facility | | $4,265.80 | $21,379.62 | $41,686.94 |