- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $13,803.84 / $23,988.33
| Facility | | $1,288.25 | $13,803.84 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $758.58 / $870.96
| Facility | | $707.95 | $758.58 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,513.56 / $21,877.62
| Facility | | $1,000.00 | $1,513.56 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,905.46 / $2,041.74
| Facility | | $1,621.81 | $1,905.46 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,380.38
| Facility | | $1,348.96 | $1,348.96 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $36,307.81 / $70,794.58
| Facility | | $28,183.83 | $36,307.81 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $21,379.62 / $41,686.94
| Facility | | $4,265.80 | $21,379.62 | $41,686.94 |