- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $7,943.28 / $21,877.62
| Facility | | $1,995.26 | $7,943.28 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $870.96
| Facility | | $758.58 | $758.58 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,137.96 / $14,791.08
| Facility | | $1,047.13 | $2,137.96 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,041.74 / $2,137.96
| Facility | | $1,737.80 | $2,041.74 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,445.44
| Facility | | $1,412.54 | $1,412.54 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $18,620.87 / $35,481.34
| Facility | | $14,125.38 | $18,620.87 | $35,481.34 |
- 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 |