- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,754.40 / $15,488.17
| Facility | | $1,621.81 | $5,754.40 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,220.18 / $19,054.61
| Facility | | $5,011.87 | $11,220.18 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $28,183.83
| Facility | | $1,659.59 | $1,659.59 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $6,456.54 / $50,118.72
| Facility | | $34.67 | $6,456.54 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,905.46 / $3,981.07
| Facility | | $1,202.26 | $1,905.46 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $50,118.72 / $75,857.76
| Facility | | $1,258.93 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $8,128.31 / $20,417.38
| Facility | | $2,818.38 | $8,128.31 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,479.11 / $3,801.89
| Facility | | $933.25 | $1,479.11 | $3,801.89 |