- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $9,120.11 / $35,481.34
| Facility | | $2,137.96 | $9,120.11 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $12,022.64 / $12,022.64
| Facility | | $12,022.64 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $478.63 / $933.25
| Facility | | $302.00 | $478.63 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $30,902.95 / $42,657.95
| Facility | | $21,877.62 | $30,902.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $12,022.64 / $165,958.69
| Facility | | $4,786.30 | $12,022.64 | $165,958.69 |