- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $8,128.31 / $20,892.96
| Facility | | $2,089.30 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $6,165.95
| Facility | | $912.01 | $912.01 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,818.38 / $10,964.78
| Facility | | $1,348.96 | $2,818.38 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,089.30 / $2,187.76
| Facility | | $1,548.82 | $2,089.30 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,513.56 / $1,513.56
| Facility | | $1,445.44 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $28,183.83
| Facility | | $9,549.93 | $14,791.08 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $15,135.61 / $30,199.52
| Facility | | $1,380.38 | $15,135.61 | $30,199.52 |