- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $10,232.93 / $30,199.52
| Facility | | $1,819.70 | $10,232.93 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $870.96 / $42,657.95
| Facility | | $758.58 | $870.96 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,995.26 / $46,773.51
| Facility | | $1,023.29 | $1,995.26 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,862.09 / $1,949.84
| Facility | | $1,479.11 | $1,862.09 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,318.26 / $6,918.31
| Facility | | $1,288.25 | $1,318.26 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,686.94 / $52,480.75 / $100,000.00
| Facility | | $41,686.94 | $52,480.75 | $100,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $79,432.82 / $154,881.66
| Facility | | $4,265.80 | $79,432.82 | $154,881.66 |