- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $7,762.47 / $20,892.96
| Facility | | $1,698.24 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $3,801.89
| Facility | | $741.31 | $741.31 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,949.84 / $9,549.93
| Facility | | $954.99 | $1,949.84 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $1,778.28
| Facility | | $1,096.48 | $1,548.82 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,202.26 / $1,445.44
| Facility | | $1,174.90 | $1,202.26 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $10,964.78 / $20,892.96
| Facility | | $7,943.28 | $10,964.78 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $12,022.64 / $22,387.21
| Facility | | $1,698.24 | $12,022.64 | $22,387.21 |