- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,951.21 / $15,848.93
| Facility | | $2,398.83 | $2,951.21 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $33,884.42 / $50,118.72
| Facility | | $30,199.52 | $33,884.42 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $1,023.29
| Facility | | $630.96 | $630.96 | $1,023.29 |