- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $7,762.47 / $20,892.96
| Facility | | $1,949.84 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $7,079.46
| Facility | | $1,905.46 | $1,905.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,630.27 / $10,964.78
| Facility | | $1,318.26 | $2,630.27 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,995.26 / $2,041.74
| Facility | | $1,659.59 | $1,995.26 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,412.54 / $1,862.09
| Facility | | $1,348.96 | $1,412.54 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,481.54 / $21,877.62
| Facility | | $8,317.64 | $11,481.54 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $12,882.50 / $23,442.29
| Facility | | $2,398.83 | $12,882.50 | $23,442.29 |