- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $5,495.41 / $12,882.50
| Facility | | $2,511.89 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,918.31 / $37,153.52
| Facility | | $3,467.37 | $6,918.31 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,737.80 / $3,019.95
| Facility | | $1,047.13 | $1,737.80 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $30,902.95 / $45,708.82
| Facility | | $23,988.33 | $30,902.95 | $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 |