- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $9,120.11 / $21,877.62
| Facility | | $1,230.27 | $9,120.11 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $758.58 / $8,317.64
| Facility | | $707.95 | $758.58 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,348.96 / $9,549.93
| Facility | | $691.83 | $1,348.96 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,258.93 / $1,288.25
| Facility | | $1,047.13 | $1,258.93 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $891.25 / $2,187.76
| Facility | | $851.14 | $891.25 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $38,904.51
| Facility | | $14,791.08 | $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 |