- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,495.41 / $14,125.38
| Facility | | $3,388.44 | $5,495.41 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,882.50 / $34,673.69
| Facility | | $5,128.61 | $12,882.50 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $10,715.19
| Facility | | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,778.28 / $2,818.38
| Facility | | $1,071.52 | $1,778.28 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $29,512.09 / $45,708.82
| Facility | | $23,988.33 | $29,512.09 | $45,708.82 |
- 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 |