- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $7,943.28 / $20,892.96
| Facility | | $2,041.74 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $2,290.87 / $2,511.89
| Facility | | $1,995.26 | $2,290.87 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,187.76 / $9,549.93
| Facility | | $1,148.15 | $2,187.76 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,089.30 / $2,187.76
| Facility | | $1,584.89 | $2,089.30 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,513.56
| Facility | | $1,479.11 | $1,479.11 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $38,904.51
| Facility | | $13,803.84 | $20,417.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $21,379.62 / $41,686.94
| Facility | | $4,265.80 | $21,379.62 | $41,686.94 |