- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $7,943.28 / $20,892.96
| Facility | | $1,479.11 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $933.25 / $8,317.64
| Facility | | $891.25 | $933.25 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,584.89 / $8,128.31
| Facility | | $812.83 | $1,584.89 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,479.11 / $1,548.82
| Facility | | $1,258.93 | $1,479.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,071.52 / $2,187.76
| Facility | | $1,023.29 | $1,071.52 | $2,187.76 |
- 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
- $2,454.71 / $21,379.62 / $41,686.94
| Facility | | $2,454.71 | $21,379.62 | $41,686.94 |