- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,162.28 / $6,606.93
| Facility | | $1,023.29 | $3,162.28 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $20,417.38 / $29,512.09
| Facility | | $3,890.45 | $20,417.38 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $1,412.54
| Facility | | $39.81 | $39.81 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $6,456.54 / $16,218.10
| Facility | | $1,174.90 | $6,456.54 | $16,218.10 |