- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $8,128.31 / $28,183.83
| Facility | | $1,949.84 | $8,128.31 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,071.52 / $25,703.96
| Facility | | $891.25 | $1,071.52 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,187.76 / $21,379.62
| Facility | | $1,071.52 | $2,187.76 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,089.30 / $2,187.76
| Facility | | $1,737.80 | $2,089.30 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,479.11 / $6,025.60
| Facility | | $1,445.44 | $1,479.11 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $37,153.52 / $70,794.58
| Facility | | $26,915.35 | $37,153.52 | $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 |