- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,943.28 / $20,892.96
| Facility | | $3,235.94 | $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
- $1,949.84 / $3,548.13 / $25,703.96
| Facility | | $1,949.84 | $3,548.13 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,388.44 / $3,467.37
| Facility | | $2,884.03 | $3,388.44 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,398.83
| Facility | | $2,344.23 | $2,344.23 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $36,307.81 / $70,794.58
| Facility | | $26,915.35 | $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 |