- 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
- $912.01 / $912.01 / $2,884.03
| Facility | | $912.01 | $912.01 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,089.30 / $5,888.44
| Facility | | $1,412.54 | $2,089.30 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,238.72 / $2,398.83
| Facility | | $1,905.46 | $2,238.72 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,548.82 / $1,621.81
| Facility | | $1,122.02 | $1,548.82 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,606.93 / $12,589.25
| Facility | | $4,786.30 | $6,606.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $7,244.36 / $13,182.57
| Facility | | $1,380.38 | $7,244.36 | $13,182.57 |