- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $9,120.11 / $21,877.62
| Facility | | $1,819.70 | $9,120.11 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $758.58 / $11,220.18
| Facility | | $707.95 | $758.58 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,995.26 / $12,882.50
| Facility | | $1,047.13 | $1,995.26 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,905.46 / $1,995.26
| Facility | | $1,380.38 | $1,905.46 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,348.96 / $2,951.21
| Facility | | $1,318.26 | $1,348.96 | $2,951.21 |
- 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 |