- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $7,943.28 / $20,892.96
| Facility | | $2,238.72 | $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
- $1,258.93 / $2,398.83 / $8,709.64
| Facility | | $1,258.93 | $2,398.83 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,290.87 / $2,454.71
| Facility | | $1,905.46 | $2,290.87 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,659.59 / $2,187.76
| Facility | | $1,621.81 | $1,659.59 | $2,187.76 |
- 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 |