- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,511.38 / $16,982.44
| Facility | | $2,344.23 | $8,511.38 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $14,125.38 / $56,234.13
| Facility | | $8,317.64 | $14,125.38 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,235.94 / $15,848.93
| Facility | | $1,548.82 | $3,235.94 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $44,668.36 / $72,443.60
| Facility | | $30,902.95 | $44,668.36 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $11,748.98 / $29,512.09
| Facility | | $2,570.40 | $11,748.98 | $29,512.09 |