- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,801.89 / $12,882.50
| Facility | | $1,096.48 | $3,801.89 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,801.89 / $7,413.10
| Facility | | $2,137.96 | $3,801.89 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $537.03 / $575.44
| Facility | | $537.03 | $537.03 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,862.09 / $2,344.23
| Facility | | $954.99 | $1,862.09 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $33,884.42 / $33,884.42
| Facility | | $7,943.28 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $724.44 / $2,238.72
| Facility | | $524.81 | $724.44 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $691.83 / $1,202.26
| Facility | | $524.81 | $691.83 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,011.87 / $10,964.78
| Facility | | $1,698.24 | $5,011.87 | $10,964.78 |