- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $5,248.07 / $12,302.69
| Facility | | $2,570.40 | $5,248.07 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,481.54 / $20,892.96
| Facility | | $5,011.87 | $11,481.54 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $18,620.87
| Facility | | $3,162.28 | $3,162.28 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $3,801.89 / $50,118.72
| Facility | | $34.67 | $3,801.89 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,162.28 / $7,943.28
| Facility | | $2,187.76 | $3,162.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $50,118.72 / $75,857.76
| Facility | | $2,818.38 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $9,332.54
| Facility | | $1,513.56 | $4,168.69 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,818.38 / $3,548.13
| Facility | | $1,737.80 | $2,818.38 | $3,548.13 |