- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $16,595.87 / $28,183.83
| Facility | | $1,862.09 | $16,595.87 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $6,918.31
| Facility | | $4,168.69 | $4,168.69 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,290.87 / $15,848.93
| Facility | | $1,288.25 | $2,290.87 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,862.09 / $1,949.84
| Facility | | $1,584.89 | $1,862.09 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,348.96 / $1,348.96
| Facility | | $1,318.26 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,595.87 / $31,622.78
| Facility | | $10,964.78 | $16,595.87 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $20,417.38 / $35,481.34
| Facility | | $3,467.37 | $20,417.38 | $35,481.34 |