- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $2,818.38 / $7,244.36
| Facility | | $870.96 | $2,818.38 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $28,183.83 / $39,810.72
| Facility | | $2,884.03 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $602.56 / $676.08
| Facility | | $537.03 | $602.56 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $562.34 / $1,202.26
| Facility | | $354.81 | $562.34 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $10,964.78
| Facility | | $4,073.80 | $7,762.47 | $10,964.78 |