- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,073.80 / $11,481.54
| Facility | | $2,454.71 | $4,073.80 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,481.54 / $18,620.87
| Facility | | $4,897.79 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $37,153.52
| Facility | | $3,548.13 | $3,548.13 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $4,168.69 / $50,118.72
| Facility | | $34.67 | $4,168.69 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,168.69 / $8,709.64
| Facility | | $2,398.83 | $4,168.69 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $50,118.72 / $75,857.76
| Facility | | $2,511.89 | $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
- $1,995.26 / $2,884.03 / $10,232.93
| Facility | | $1,995.26 | $2,884.03 | $10,232.93 |