- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $13,489.63 / $34,673.69
| Facility | | $1,412.54 | $13,489.63 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $13,182.57
| Facility | | $707.95 | $870.96 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,479.11 / $12,589.25
| Facility | | $776.25 | $1,479.11 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,380.38 / $1,479.11
| Facility | | $1,023.29 | $1,380.38 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,000.00 / $3,019.95
| Facility | | $977.24 | $1,000.00 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $38,904.51
| Facility | | $14,791.08 | $20,417.38 | $38,904.51 |
- 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 |