- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,481.54 / $34,673.69
| Facility | | $4,897.79 | $11,481.54 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $11,748.98 / $20,892.96
| Facility | | $6,918.31 | $11,748.98 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $1,778.28 / $35,481.34
| Facility | | $75.86 | $1,778.28 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $23,988.33
| Facility | | $9,549.93 | $14,791.08 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $870.96 / $1,096.48
| Professional | | $602.56 | $870.96 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $977.24 / $1,905.46
| Professional | | $741.31 | $977.24 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,445.44 / $19,054.61
| Facility | | $954.99 | $1,445.44 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $20,892.96 / $46,773.51
| Facility | | $10,715.19 | $20,892.96 | $46,773.51 |