- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $7,943.28 / $20,892.96
| Facility | | $1,230.27 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $933.25 / $10,964.78
| Facility | | $891.25 | $933.25 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,288.25 / $12,022.64
| Facility | | $616.60 | $1,288.25 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,202.26 / $1,318.26
| Facility | | $933.25 | $1,202.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $912.01 / $2,951.21
| Facility | | $870.96 | $912.01 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $38,904.51
| Facility | | $13,803.84 | $20,417.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $21,379.62 / $41,686.94
| Facility | | $3,467.37 | $21,379.62 | $41,686.94 |